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CASE REPORT
Neonatal isolated ACTH deficiency (IAD): a potentially life-threatening but treatable cause of neonatal cholestasis
  1. Mahdi Alsaleem1,2,
  2. Lina Saadeh1,2,
  3. Amrit Misra2,
  4. Shailender Madani2
  1. 1Detroit Medical Center, Detroit, Michigan, USA
  2. 2Wayne State University, Detroit, Michigan, USA
  1. Correspondence to Dr Mahdi Alsaleem, malsalee{at}dmc.org

Summary

Isolated ACTH deficiency (IAD) is a rare cause of neonatal cholestasis and hypoglycaemia. This diagnosis has a 20% mortality potential if unrecognised. We describe a case of an infant presenting with cholestatic jaundice and hypoglycaemia. The patient had laboratory findings suggestive of IAD, which was later confirmed with molecular genetic testing. One of the mutations this patient had is a new finding. The patient was started on glucocorticoid replacement therapy after which his bilirubin and glucose levels normalised.

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