AN ADULT CASE OF NEUROHYPOPHYSEAL ECTOPY PRESENTING ACTH DEFICIENCY AND PARTIAL GH DEFICIENCY

A case of ACTH deficiency and partial GH deficiency associated with ne urohypophyseal ectopy is described. A 42-year-old woman of short statu re was admitted for hypoglycemic coma. The patient had hypocortisolemi a, an increase in urinary 17-OHCS after consecutive injections of ACTH -Z, and a low plasma ACTH level which showed no response to corticotro pin-releasing factor. This indicated the presence of ACTH deficiency. The plasma GH level showed a blunted response to insulin-induced hypog lycemia, but its response to GRF was preserved. Other hypothalamo-pitu itary axes were intact. T1-weighted magnetic resonance imaging demonst rated ectopic neurohypophyseal tissue and a tiny anterior pituitary re mnant. ACTH deficiency and partial GH deficiency might have developed as a consequence of pituitary stalk injury and inadequate regeneration of the anterior lobe.