Recovery of hypothalamic-pituitary-adrenal function, growth hormone responsiveness and sleep EEG pattern in a patient following removal of an adrenal cortical adenoma.

Abstract

ABSTRACT A patient with Cushing's syndrome secondary to an adrenal cortical adenoma exhibited low plasma ACTH levels, diminished adrenal responsiveness to ACTH, absence of circadian periodicity of plasma ACTH and cortisol levels, absence of plasma ACTH, cortisol and growth hormone response to hypoglycemia or Pitressin® administration and absence of the nocturnal elevation of plasma growth hormone levels. EEG sleep stages III and IV were absent and there was an increase in the percentage of Stage I sleep and a reduction in REM periods. Repeat studies were performed 3¾12, 7, 12 and 16 months postoperatively. Return of normal adrenal responsiveness to ACTH, normal basal plasma ACTH and growth hormone levels, and normal plasma ACTH, cortisol and growth hormone responses to Pitressin® and hypoglycemia were noted in the study 3¾12 months postoperatively. Circadian periodicity of plasma ACTH and cortisol levels and nocturnal elevation of plasma growth hormone levels was not evident until 7 months postoperatively...