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Reversible Hypothyroidism With Corticotropin Releasing Hormone Deficiency
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Reversible hypothyroidism after corticosteroid replacement therapy has been reported in association with primary and secondary adrenal insufficiencies (Addison disease1-2 and isolated adrenocorticotropic hormone deficiency3). We report a case of reversible hypothyroidism in a patient diagnosed as having corticotropin releasing hormone deficiency.
Report of a Case
A 72-year-old woman was admitted because of a loss of consciousness induced by hypoglycemia (blood glucose level, 2.3 mmol/L [41 mg/dL]). There was no significant family or personal history of excess iodine intake. Her serum free thyroxine level was 14 pmol/L (1.1 ng/dL) (normal range, 11-27 pmol/L [0.85-2.15 ng/dL]), her free triiodothyronine level was 0.03 pmol/L (normal range, 0.04-0.09 pmol/L), and her thyrotropin level was 32.2 µIU/L (normal range, 0.3-3.5 µIU/L). Basal serum cortisol and adrenocorticotropic hormone levels were 110.4 nmol/L (normal range, 121.4-480.1 nmol/L) and 264.2 nmol/L (normal range, 134.3-1211.1 nmol/L), respectively. Urinary excretion of free cortisol was abnormally low. Basal levels of other hormones (growth hormone, . . . [Full Text of this Article] Comment
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ABSTRACT
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