PITUITARY INSUFFICIENCY ASSOCIATED WITH DIABETES MELLITUS

Abstract

A case is reported of diabetes mellitus and partial pituitary insufficiency, presenting as myxedema. Thyroid function before and after giving thyrotropic hormone (TSH) was tested with radioactive iodine (I131), and on both occasions the thyroidal I131 uptake was negligible and suggestive of that observed in myxedema. There was, however, some metabolic response to TSH. Studies of the total 17-ketosteroid, fractionated 17-ketosteroid and corticosteroid excretion before, during and after TSH, ACTH and cortisone were carried out. Corticosteroid excretion was within normal limits, though 17-ketosteroid excretion was minimal. The response of the latter to ACTH (in which three quarters of the 17-ketosteroid was of adrenocortical origin) suggested some previous abnormal function of the adrenal cortex, in spite of normal corticosteroid excretion. Response to ACTH and extreme sensitivity to insulin supported the diagnosis of pituitary insufficiency.