Adrenocorticotropic hormone deficiency

Adrenocorticotropic hormone deficiency is a rare disorder in which the body makes too little ACTH, the pituitary signal that tells the adrenal glands to produce cortisol. It is described as a form of secondary adrenal insufficiency, with minimal or no cortisol production while the other pituitary hormones are secreted normally. The condition may be congenital or acquired, and its symptoms resemble those of glucocorticoid deficiency: weight loss, diminished appetite, muscle weakness, nausea, vomiting and low blood pressure. Low blood sugar and low sodium are possible, but potassium usually stays normal because the renin-angiotensin-aldosterone system remains intact, so patients lack glucocorticoids rather than mineralocorticoids. Blood tests may show undetectable ACTH and abnormally low cortisol. Glucocorticoid replacement therapy is required, although some people with mild or nearly symptom-free disease may not need it outside stressful situations. As of 2008 about two hundred cases had been described in the literature.