Isolated adrenocorticotrophic hormone deficiency in the absence of polyglandular endocrinopathy. A case report.

A 64-year-old woman presented with recurrent episodes of confusion and nonspecific abdominal symptoms associated with hyponatraemia, which prompted a provisional diagnosis of the syndrome of inappropriate antidiuretic hormone secretion. Further investigation revealed evidence of hypocortisolaemia secondary to isolated adrenocorticotrophic hormone (ACTH) deficiency, which was successfully treated with steroid therapy. The clinical spectrum and aetiological associations of isolated ACTH deficiency are reviewed.