Matsuo Kinya, Koga Michiaki, Oishi Mariko, Kawai Motoharu, Kanda Takashi
Department of Neurology and Clinical Neuroscience, Yamaguchi University Graduate School of Medicine, Japan.
Intern Med. 2020 Jan 1;59(1):119-120. doi: 10.2169/internalmedicine.3234-19. Epub 2019 Jul 31.
Isolated adrenocorticotropic hormone deficiency (IAD) is a cause of adrenal insufficiency (AI), which shows impaired secretion of adrenocorticotropic hormone (ACTH) with the preserved secretion of other anterior pituitary gland hormones. We herein report a case of IAD complicated by chronic thyroiditis presenting with neuropsychiatric symptoms without other signs indicative of AI that showed complete improvement of the cognitive function after the administration of corticosteroids. The clinical features of our case may be confused with autoimmune encephalopathies (AEs); however, IAD should be strictly differentiated from AEs, as it requires permanent hormone replacement without addition of immunosuppressive agents.
孤立性促肾上腺皮质激素缺乏症（IAD）是肾上腺功能不全（AI）的一个病因，其表现为促肾上腺皮质激素（ACTH）分泌受损，而其他垂体前叶激素分泌正常。我们在此报告一例IAD合并慢性甲状腺炎的病例，该病例表现为神经精神症状，无其他提示AI的体征，在给予皮质类固醇后认知功能完全改善。我们病例的临床特征可能与自身免疫性脑病（AE）相混淆；然而，IAD应与AE严格区分，因为它需要长期激素替代治疗，无需添加免疫抑制剂。
