A Case of Addison's Disease Confirmed with Low Dose Cosyntropin Stimulation Test

Endocrine Journal

Hiroshi WATANABE¹  Masayasu YONEDA¹  Nobuoki KOHNO¹  Kiminori YAMANE¹  Kenji OKI¹  Hideki NOJIMA¹ 

[1] Department of Molecular and Internal Medicine, Graduate School Biomedical Sciences, Hiroshima University

关键词: Addison's disease;    Cosyntropin stimulation test;    Skin pigmentation;   

DOI  :  10.1507/endocrj.K06-216

学科分类：内分泌与代谢学

来源: Japan Endocrine Society

【 摘 要 】

References(19)Cited-By(1)An eighty-year-old man who had complained of skin pigmentation and weight loss was referred to our hospital. Upon physical examination, marked hyperpigmentation was found on the whole body including oral mucosa, tongue and fingernails. Endocrinological findings showed increased ACTH (126 pg/ml) and normal serum cortisol (15.4 μg/dl). First, we used a 250 μg cosyntropin stimulation test which is valid to diagnose Addison's disease, resulting in an adequate cortisol response. Second, we performed 1 μg cosyntropin stimulation test, and the cortisol response was blunted. Since the diagnosis of Addison's disease was fairly certain, he was treated with hydrocortisone 15 mg/day, and improvement of his skin pigmentation and an increase in body weight were observed. To our knowledge, this is the first report that 1 μg cosyntropin stimulation test was helpful to make diagnosis as having Addison's disease rather than the 250 μg cosyntropin stimulation test, although it is established that the 1 μg cosyntropin stimulation test is useful in secondary or relative adrenal insufficiency.

【 授权许可】

Unknown