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- Title
Isolated corticotropin deficiency in chronic alcoholism.
- Authors
Kearney, T.; Robinson, S.; Johnston, D.G.
- Abstract
Three patients who chronically abused alcohol were found to be hyponatraemic with normal plasma potassium. The first had been admitted with confusion and weight loss, the second with hypotension and sepsis, and the third with confusion and hypoglycaemia-induced seizures. All three patients had a subnormal cortisol response in the short synacthen test; however, the plasma cortisol after three days of tetracosactric administration was greater than 500 nmol/L. Baseline corticotropin levels were less than 10pg/mL in all three. No structural lesions of the hypothalamo-pituitary tract were found and there was no evidence of other endocrinopathies. Glycocorticoid replacement therapy led to the resolution of hyponatraemia and hypoglycaemia, where present, and to clinical improvement. The two surviving patients remained hypocortisolaemic in the long term, without recurrence of hyponatraemia or hypoglacaemia. The features of isolated corticotropin deficiency are easily confused with other effects of chronic alcohol abuse. In alcoholic patients with unexplained hyponatraemia, hypoglycaemia or haemodynamic instability, a short tetracosactrin test is advisable.
- Subjects
ALCOHOLISM; ADRENOCORTICOTROPIC hormone; HYDROCORTISONE; HYPONATREMIA; POTASSIUM deficiency diseases
- Publication
Journal of the Royal Society of Medicine, 2000, Vol 93, Issue 1, p15
- ISSN
0141-0768
- Publication type
Article
- DOI
10.1177/014107680009300105