Vol. 33 (2) 2012 Neuro endocrinology letters

Paradoxical surge of corticotropin after glucocorticoid replacement in central adrenal insufficiency.

: A 78-yr-old man was admitted in emergency with fatigue, anorexia, vomiting, hypothermia (35.1 °C on a hot August day), hypotension (89/56 mmHg) and hyponatraemia (126 mEq/l). Plasma corticotropin and cortisol were severely depressed: 0.84 pmol/L and 33.1 nmol/L respectively (reference range, 1.5-13.9 pmol/L and 110-505 nmol/L, respec.....