Idiopathic combined adrenocorticotropin and growth hormone deficiency mimicking chronic fatigue syndrome

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Abstract

A 42-year-old man who had suffered from severe fatigue for 5 years was diagnosed as having chronic fatigue syndrome (CFS) and fibromyalgia. Endocrinological workup using combined anterior pituitary function tests showed that the patient had adrenocorticotropin hormone (ACTH) deficiency, with a normal pituitary MRI. Treatment with a physiologic dose of oral hydrocortisone replacement physically ameliorated his general fatigue. A secondary workup using a growth hormone-releasing peptide-2 test revealed that he also had growth hormone (GH) deficiency, and GH replacement therapy was started. His muscle pain and depression were improved by the therapy. Here, we present a rare case of combined deficiency of ACTH and GH in a middle-aged man with severe general fatigue. This case report aims to raise awareness of combined deficiency of ACTH and GH as a differential diagnosis of CFS and its mimics.

Original languageEnglish
JournalBMJ Case Reports
Volume14
Issue number10
DOIs
Publication statusPublished - Oct 22 2021
Externally publishedYes

Keywords

  • adrenal disorders
  • general practice / family medicine
  • pituitary disorders

ASJC Scopus subject areas

  • Medicine(all)

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