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.
Adrenocortical Insufficiency - Corticotropin Releasing Factor - Lysine- Vasopressin
Test
