Vittecoq D, Bognel J C, Najman A, Sebaoun J, Modigliani E
Ann Med Interne (Paris). 1982;133(3):182-5.
The paper describes the case of a 38 year's old alcoholic patient. The investigation of his severe asthenia led to the discovery of an isolated ACTH deficiency: plasma cortisol was less than 1 microgram 100 ml reactivable by tetracosa-peptide beta 1-24. Plasma ACTH was low and remained so after LVD and metyrapone. Persistent leuconeutropenia without myelogram and agar cultures abnormalities was noted. Etiocholanolone test was negative and epinephrine induced a significant rise in blood leucocytes. The authors review the mechanisms of corticoid action on leucopoiesis. After 10 months corticoid treatment, leuconeutropenia improved but was still present suggesting an other underlying mechanism than cortisol insufficiency per se.
该论文描述了一名38岁酗酒患者的病例。对其严重乏力进行检查后发现单独的促肾上腺皮质激素（ACTH）缺乏：血浆皮质醇低于1微克/100毫升，用四肽β1 - 24可使其恢复。血浆ACTH水平低，在使用促皮质素释放素（LVD）和甲吡酮后仍维持低水平。观察到持续性白细胞减少症，骨髓象和琼脂培养无异常。本胆烷醇酮试验为阴性，肾上腺素可使血液白细胞显著升高。作者回顾了皮质激素对白细胞生成的作用机制。经过10个月的皮质激素治疗，白细胞减少症有所改善但仍然存在，提示除皮质醇不足本身外还有其他潜在机制。
