Isolated adrenocorticotropin deficiency as a rare cause of hypoglycaemia in children. Further studies and report of an additional case

Abstract

An 11.5-year-old boy presented with recurrent attacks of hypoglycaemic coma. Endocrine investigations indicated adrenocortical insufficiency secondary to isolated ACTH deficiency, how ACTH and cortisol plasma levels with normal secretory reserve of other anterior pituitary hormones. The absence of ACTH response after corticotropin releasing factor and insulin-induced hypoglycaemia suggested a failure of primary pituitary ACTH-secreting cells. Among other hormone-secreting cells, pituitary cell circulating antibodies were negative. CT scan and MRI failed to reveal any anatomical abnormality of the sella or suprasellar area.