98.4.3-Case Presentation Isolated ACTH def.

Endocrine Grand Round 
A 72 YEAR OLD MAN WITH ANOREXIA

By:

Dr.yaghoobpour

Presenter:

Dr.forouzandeh Sadrzadeh

Chief complaint:
Anorexia

21. Present illness:
21. 72 year old man /from Tehran/neurosurgeon/presented with anorexia and 20 kg weight loss during one year.
21. Followed by sudden sever weakness and brief loss of consciousness one year ago .he was admitted to ICU and received supportive care.
21. SBP was low he was hydrated with normal saline and hydrocortisone
21. TSH >100   levothyroxine was started
21. He was discharged with a diagnosis of hypothyroidism

Accompanying symptoms

21. Weight loss(20 kg)
21. Fatigue(+)
21. Weakness(+)
21. Nausea and vomiting(-)
21. Headache(-)
21.  Memory impairment(-)
21. Hypoglycemia(-)
21. Libido loss(-)
21. Orthostatic hypotension(-)
21. Blurred vision(-)
21. Hyper pigmentation(-)
21. Hyponatremia(+)