Abstract
We report a case of a patient with isolated ACTH deficiency presenting with non-specific symptoms including fatigability and anorexia. A case was a 65 year-old male. The patient was referred from the Department of Gastrointestinal Medicine to our department for close examination of these chief complaints. The patient was hospitalized on the first visit due to the onset of presyncope induced by hypotension at the initial examination. Adrenocortical insufficiency was suspected because of persistent hypoglycemia during hospitalization and the patient was referred to the Department of Endocrinology and Metabolism. There, the patient was definitely diagnosed as adrenocortical insufficiency secondary to isolated ACTH deficiency. Adrenocortical insufficiency is fatal in some patients and it is difficult to make a definite diagnosis if isolated ACTH deficiency is not considered. Therefore, isolated ACTH deficiency should be suspected in middle-aged and elderly persons who develop malaise, fatigability, weight loss, hypoglycemia, and anorexia without a clear pathology
