Adrenocorticotropic hormone deficiency

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Adrenocorticotropic hormone deficiency
Synonyms	ACTH deficiency
Pronounce	N/A
Specialty	N/A
Symptoms	Fatigue, weight loss, hypoglycemia, nausea, vomiting, muscle weakness
Complications	Adrenal crisis, hypotension, shock
Onset	Can occur at any age
Duration	Chronic
Types	N/A
Causes	Pituitary gland dysfunction, genetic mutations, autoimmune disorders
Risks	Autoimmune polyglandular syndrome, pituitary tumors, head trauma
Diagnosis	Blood test for ACTH levels, stimulation test
Differential diagnosis	Addison's disease, secondary adrenal insufficiency
Prevention	N/A
Treatment	Hormone replacement therapy, glucocorticoids
Medication	Hydrocortisone, prednisone
Prognosis	Good with treatment
Frequency	Rare
Deaths	Rare, if untreated

Adrenocorticotropic hormone deficiency (ACTH deficiency) is a condition characterized by the insufficient production of adrenocorticotropic hormone (ACTH) by the pituitary gland. ACTH is crucial for stimulating the adrenal glands to produce cortisol, a hormone essential for maintaining various bodily functions, including metabolism and immune response.

Causes

ACTH deficiency can be caused by several factors, including:

• Pituitary gland disorders, such as pituitary adenomas or hypopituitarism.
• Genetic mutations affecting the development or function of the pituitary gland.
• Autoimmune diseases that damage the pituitary gland.
• Traumatic brain injury or surgery affecting the pituitary region.
• Radiation therapy targeting the pituitary gland.

Symptoms

The symptoms of ACTH deficiency are primarily due to low levels of cortisol and may include:

• Fatigue and weakness.
• Weight loss and decreased appetite.
• Hypoglycemia (low blood sugar).
• Nausea, vomiting, and abdominal pain.
• Low blood pressure and dizziness.
• Depression and irritability.

Diagnosis

Diagnosis of ACTH deficiency involves:

• Measuring blood levels of ACTH and cortisol.
• Performing a stimulation test to assess adrenal gland function.
• Imaging studies, such as MRI of the pituitary gland, to identify structural abnormalities.

Treatment

Treatment for ACTH deficiency focuses on replacing the deficient hormones and may include:

• Glucocorticoid replacement therapy to substitute for cortisol.
• Monitoring and adjusting hormone levels to prevent adrenal crisis.
• Addressing any underlying causes, such as treating pituitary tumors.

Prognosis

With appropriate treatment, individuals with ACTH deficiency can lead normal lives. However, they must be vigilant about managing their condition, especially during times of stress or illness, to prevent adrenal crisis.

See Also

• Adrenal insufficiency
• Cushing's syndrome
• Hypopituitarism
• Endocrinology