Isolated Adrenocorticotropic Hormone Deficiency Presenting With Arthritis: A Case Report

Mod Rheumatol Case Rep. 2024 Oct 3:rxae057. doi: 10.1093/mrcr/rxae057. Online ahead of print.

Abstract

This case report describes a case of isolated adrenocorticotropic hormone (ACTH) deficiency that presented with arthritis. Initial investigations, including blood tests, imaging, and musculoskeletal ultrasonography, did not confirm to any specific connective tissue disease, making it initially difficult to identify the cause of the arthritis. Subsequent adrenal crisis led to the diagnosis of isolated ACTH deficiency through comprehensive endocrine evaluation. The patient's musculoskeletal symptoms were resolved following corticosteroid replacement therapy together with generalized symptoms. This report highlights isolated ACTH deficiency as a rare but one of the causes of polyarticular joint pain and underscores the importance of considering endocrine disorders in the differential diagnosis of unexplained arthritis, particularly when accompanied by systemic symptoms.

Keywords: adrenal crisis; arthritis; isolated ACTH deficiency; musculoskeletal manifestations; polyarticular joint pain.