Isolated Adrenocorticotropic Hormone Deficiency Associated With Hashimoto's Disease and Thyroid Crisis Triggered by Head Trauma -Case Report
| Autor: | Takafumi Tanei, Masaki Hirano, Yuka Yamamoto, Youko Eguchi, Norimoto Nakahara, Shigenori Takebayashi |
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| Rok vydání: | 2012 |
| Předmět: |
Male
endocrine system medicine.medical_specialty Subarachnoid hemorrhage Hashimoto's disease Encephalopathy Hashimoto Disease Adrenocorticotropic hormone Internal medicine Craniocerebral Trauma Humans Medicine Hydrocortisone Brain Diseases business.industry Thyroid Crisis Glasgow Coma Scale Middle Aged medicine.disease Treatment Outcome Endocrinology Brain Injuries Anesthesia Encephalitis Surgery Neurology (clinical) business Adrenocorticotropic hormone deficiency Adrenal Insufficiency medicine.drug |
| Zdroj: | Neurologia medico-chirurgica. 52:44-47 |
| ISSN: | 1349-8029 0470-8105 |
| DOI: | 10.2176/nmc.52.44 |
| Popis: | A 47-year-old man presented to our hospital after suffering transient loss of consciousness and falling to the floor. On admission, his Glasgow Coma Scale score was 11 (E3V3M5), and he exhibited restlessness. Blood examination revealed hyperthyroidism. Computed tomography showed slight traumatic subarachnoid hemorrhage. He developed fever and tachycardia, and was diagnosed with thyroid crisis. Magnetic resonance imaging showed a brain contusion in the right frontal lobe, and encephalopathy signs in the right frontal and insular cortex. Immunocytochemical examinations suggested Hashimoto's disease, and hormone examinations revealed plasma levels were undetectably low of adrenocorticotropic hormone (ACTH) and low of cortisol. Pituitary stimulation tests showed inadequate plasma ACTH and cortisol response, consistent with isolated ACTH deficiency (IAD). The final diagnosis was IAD associated with Hashimoto's disease. Hydrocortisone replacement therapy was continued, and the patient was nearly free from neurological deficits after 18 months. The neuroimaging abnormalities gradually improved with time. |
| Databáze: | OpenAIRE |
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