A case of posttraumatic acth deficiency that initial skin finding suggesting cushing syndrome
Hipofizer adrenokortikotropik hormon (ACTH) eksikliği sekonder adrenal yetmezlik nedenlerinden birisidir. Genetik nedenler, otoimmünite, infiltratif hastalıklar, kafa travmaları ACTH yetmezliğine neden olabilmektedir. Primer adrenal yetmezlikte hiperpigmente deri lezyonları beklenirken, sekonder adrenal yetmezlikte çok nadirdir. Strialar derinin gerilimine dik olarak yerleşmiş atrofik bandlardır ve patogenezi tam olarak açıklanmamıştır. Çoğunlukla obezite, gebelik, hiperkortizolizm ile ilişkilidir. Hipokortizolemide stria beklenen bir bulgu değildir. Bu yazımızda, her iki koltukaltındaki striaları nedeniyle değerlendirdiğimiz 34 yaşındaki erkek olguyu sunduk. Olgunun öyküsünde 12 yıl önce geçirdiği kafa travması ve ameliyat öyküsü mevcuttu. Bazal kortizol ve ACTH düzeyleri sırasıyla 0,18 ug/dl and
Başlangıç cilt bulguları cushing sendromunu düşündüren posttravmatik ACTH eksikliği olgusu
Pituitary adrenocorticotropic hormone (ACTH) deficiency is one cause of secondary adrenal insufficiency. Genetic factors, autoimmunity, infiltrative disease, cranial trauma may cause ACTH deficiency. Hyperpigmented skin lesions are expected in primary adrenal insufficiency while they are very rare in secondary adrenal insufficiency. Striae are characterized by linear smooth bands of atrophic appearing skin and pathogenesis is not understood. They are mostly associated with obesity, pregnancy, hypercortisolism. Striae are not an expected finding in hypocortisolemia. We presented a 34-year-old male patient that evaluated for striae on both axillas. He had head trauma and operation 12 years ago. Basal hypophysis hormone levels and dynamic tests were conducted. Basal cortisol and ACTH level were 0,18 ug/dl and
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