Case Report: Idiopathic combined adrenocorticotropin and growth hormone deficiency mimicking chronic fatigue syndrome, 2021, Tokumasu et al

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.

Paywall, https://casereports.bmj.com/content/14/10/e244861

 

The full text is available for free here:
https://ousar.lib.okayama-u.ac.jp/files/public/6/62847/20211109090549746324/fulltext20211109-1.pdf