Study on Transient Adenocorticotropic Hormone Deficiency in an Infant | Chapter 16 | Issues and Developments in Medicine and Medical Research Vol. 8

 Background: Adenocorticotropin Hormone (ACTH) deficiency is a rare condition marked by secondary adrenal insufficiency with low or nonexistent cortisol production, adequate pituitary hormone release, and the absence of anatomical pituitary abnormalities.

The purpose of this study is to describe a premature newborn who was found to have a transitory ACTH deficit.

Summary of the Case: The patient was the result of a clomiphen-induced 28-week pregnancy in a 40-year-old gestational diabetic mother. He was ventilated for 30 days and diagnosed with Retina of Prematurity, Grade IV (ROP). He had recurrent hypoglycemia crises, with blood sugar levels of 1.6 mmol/L, low serum cortisol levels of 65 nmol/L (normal; 150-630), and ACTH levels of 1.5 pmol/L (normal; 1.6-13.9), as well as suppressed serum insulin and normal thyroid, growth hormone, and gonadal activities. The results of the magnetic resonance imaging (MRI) were unremarkable. He was started on 2.5 mg of hydrocortisone twice a day for two years, then gradually tapered and terminated. With a normal shot ACTH stimulation test, serum cortisol was 175 nmol/L and ACTH was 5.5 pmol/L.

Conclusions: This premature baby's recurring hypoglycemia was caused by an individual ACTH deficit that was found to be temporary. The existence of such a disorder must be known to paediatricians.

Author(S) Details

Nasir A. M. Al Jurayyan
Department of Pediatrics, College of Medicine and King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.

Sharifah D. A. Al Issa
Department of Pediatrics, College of Medicine and King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.

Rushaid N. A. Aljurayyan
Radiology and Medical Imaging, College of Medicine and King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.

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