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Horm Metab Res 1976; 8(6): 470-474
DOI: 10.1055/s-0028-1093598
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© Georg Thieme Verlag KG Stuttgart · New York

Adrenal Insufficiency Secondary to Hypothalamic Corticotropin Releasing Factor (CRF) Insufficiency with Hyperpigmentation: A Case Report[*]

H. L. Fehm1 , K. H. Voigt2 , R.  Lang1 , W. D. Hetzel1 , E. F. Pfeiffer1
  • 1Center of Internal Medicine and Pediatrics, Department of Endocrinology and Metabolism, University of Ulm, Ulm, Germany
  • 2Center of Biology and Theoretical Medicine, Department of Physiology, University of Ulm, Ulm, Germany
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Publication History

Publication Date:
23 December 2008 (online)

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Abstract

Partial adrenocortical insufficiency as a result of an insufficiency of the hypothalamic corticotropin releasing factor (CRF) was demonstrated in a 53-year-old female patient. Somatotropic, gonadotropic and thyrotropic functions of the pituitary gland were shown to be normal by a simultaneous pituitary stimulation test. This held true especially for the adrenocorticotrophic function: administration of lysinevasopressin induced a normal rise in immunoreactive plasma- ACTH. Thus, a pituitary defect as primary cause of the disease could be excluded and evidence was provided that there was a lack in hypothalamic stimulation of ACTH-secretion. An enigmatic feature in this patient was that in the absence of elevated ACTH levels hyperpigmentation of the skin existed. Possible explanations are discussed.

Key words

Adrenocortical Insufficiency - Corticotropin Releasing Factor - Lysine- Vasopressin Test

1 Supported by the Deutsche Forschungsgemeinschaft, Project B2 (SFB 87)

1 Supported by the Deutsche Forschungsgemeinschaft, Project B2 (SFB 87)

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