ACTH Deficiency in Children and Adolescents (Clinical and Psychological Aspects)

Abstract

Publisher Summary This chapter discusses a study that was conducted to analyze the clinical and psychological aspects of adolescents with adrenocorticotropic hormone (ACTH) deficiency of hypothalamic or pituitary origin. The ACTH test was within normal limits in all instances tested. The basic urinary excretion of 17-hydroxycorticosteroid (17-OHCS) and 17-ketosteroids (17 KS) was always low for age. Isolated ACTH deficiency has been described only in adults. The only case reported of an adolescent girl appeared to present a human growth hormone (HGH) deficiency as well. The clinical picture of ACTH deficiency in the pediatric age group can only be inferred from signs of adrenal insufficiency, but there is evidence that indicates that, clinically, primary corticotropin-releasing factor (CRF) or ACTH deficiency is not completely identical with primary adrenal insufficiency. Most of the patients with pituitary insufficiency had distinctly below average intelligence quotients. Wide fluctuations were noted in this group, with the ACTH-deficient subjects ranking in IQ between the group with hereditary IR–biologically inactive HGH at the lower extreme, and the group with sporadic (most probably acquired) lack of HGH having highest ratings.