Isolated Adrenocorticotropic Hormone Deficiency Secondary to Chronic Opiate Use

Although opiate use can result in various endocrine disorders, isolated adrenocorticotropic hormone (ACTH) deficiency resulting in secondary adrenal insufficiency remains uncommon. We present a case of a 54-year-old woman with a history of chronic opiate use who presented with a four-month history o...

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Autores principales: Raj, Rishi, Jacob, Aasems, Elshimy, Ghada, Smith, Jackson
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7431316/
https://www.ncbi.nlm.nih.gov/pubmed/32821615
http://dx.doi.org/10.7759/cureus.9270
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author Raj, Rishi
Jacob, Aasems
Elshimy, Ghada
Smith, Jackson
author_facet Raj, Rishi
Jacob, Aasems
Elshimy, Ghada
Smith, Jackson
author_sort Raj, Rishi
collection PubMed
description Although opiate use can result in various endocrine disorders, isolated adrenocorticotropic hormone (ACTH) deficiency resulting in secondary adrenal insufficiency remains uncommon. We present a case of a 54-year-old woman with a history of chronic opiate use who presented with a four-month history of worsening fatigue and syncopal episodes. Laboratory workup revealed a low ACTH with low baseline cortisol and normal levels of rest of the anterior pituitary hormones. The imaging study did not reveal any pituitary abnormality. The patient was diagnosed with opiate-induced isolated ACTH deficiency. Her symptoms improved after treatment with hydrocortisone. This case would further improve clinician's awareness towards opiate-induced endocrinopathies, including isolated ACTH deficiency, which can present with nonspecific signs and symptoms, creating a diagnostic challenge.
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spelling pubmed-74313162020-08-18 Isolated Adrenocorticotropic Hormone Deficiency Secondary to Chronic Opiate Use Raj, Rishi Jacob, Aasems Elshimy, Ghada Smith, Jackson Cureus Endocrinology/Diabetes/Metabolism Although opiate use can result in various endocrine disorders, isolated adrenocorticotropic hormone (ACTH) deficiency resulting in secondary adrenal insufficiency remains uncommon. We present a case of a 54-year-old woman with a history of chronic opiate use who presented with a four-month history of worsening fatigue and syncopal episodes. Laboratory workup revealed a low ACTH with low baseline cortisol and normal levels of rest of the anterior pituitary hormones. The imaging study did not reveal any pituitary abnormality. The patient was diagnosed with opiate-induced isolated ACTH deficiency. Her symptoms improved after treatment with hydrocortisone. This case would further improve clinician's awareness towards opiate-induced endocrinopathies, including isolated ACTH deficiency, which can present with nonspecific signs and symptoms, creating a diagnostic challenge. Cureus 2020-07-19 /pmc/articles/PMC7431316/ /pubmed/32821615 http://dx.doi.org/10.7759/cureus.9270 Text en Copyright © 2020, Raj et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Endocrinology/Diabetes/Metabolism
Raj, Rishi
Jacob, Aasems
Elshimy, Ghada
Smith, Jackson
Isolated Adrenocorticotropic Hormone Deficiency Secondary to Chronic Opiate Use
title Isolated Adrenocorticotropic Hormone Deficiency Secondary to Chronic Opiate Use
title_full Isolated Adrenocorticotropic Hormone Deficiency Secondary to Chronic Opiate Use
title_fullStr Isolated Adrenocorticotropic Hormone Deficiency Secondary to Chronic Opiate Use
title_full_unstemmed Isolated Adrenocorticotropic Hormone Deficiency Secondary to Chronic Opiate Use
title_short Isolated Adrenocorticotropic Hormone Deficiency Secondary to Chronic Opiate Use
title_sort isolated adrenocorticotropic hormone deficiency secondary to chronic opiate use
topic Endocrinology/Diabetes/Metabolism
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7431316/
https://www.ncbi.nlm.nih.gov/pubmed/32821615
http://dx.doi.org/10.7759/cureus.9270
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