Isolated Adrenocorticotropic Hormone Deficiency Presenting With Arthritis: A Case Report.

IF 0.9 Q4 RHEUMATOLOGY Modern rheumatology case reports Pub Date : 2024-10-03 DOI:10.1093/mrcr/rxae057
Yuya Yamashita, Seidai Sato, Kaori Nii, Kensuke Mori, Keiko Haji, Nobuhito Naito, Hirokazu Ogino, Hiroshi Kawawno, Masaki Hanibuchi, Itsuro Endo, Yasuhiko Nishioka
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Abstract

This case report describes a case of isolated adrenocorticotropic hormone (ACTH) deficiency that presented with arthritis. Initial investigations, including blood tests, imaging, and musculoskeletal ultrasonography, did not confirm to any specific connective tissue disease, making it initially difficult to identify the cause of the arthritis. Subsequent adrenal crisis led to the diagnosis of isolated ACTH deficiency through comprehensive endocrine evaluation. The patient's musculoskeletal symptoms were resolved following corticosteroid replacement therapy together with generalized symptoms. This report highlights isolated ACTH deficiency as a rare but one of the causes of polyarticular joint pain and underscores the importance of considering endocrine disorders in the differential diagnosis of unexplained arthritis, particularly when accompanied by systemic symptoms.

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以关节炎为表现的孤立性促肾上腺皮质激素缺乏症:病例报告
本病例报告描述了一例伴有关节炎的孤立性促肾上腺皮质激素(ACTH)缺乏症患者。最初的检查,包括血液化验、影像学检查和肌肉骨骼超声波检查,均未确诊任何特定的结缔组织疾病,因此最初很难确定关节炎的病因。通过全面的内分泌评估,随后出现的肾上腺危象导致了孤立性促肾上腺皮质激素缺乏症的诊断。在接受皮质类固醇替代治疗后,患者的肌肉骨骼症状和全身症状均得到缓解。本报告强调了孤立性促肾上腺皮质激素缺乏症是多关节痛的罕见病因之一,并强调了在不明原因关节炎的鉴别诊断中考虑内分泌失调的重要性,尤其是在伴有全身症状时。
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