Weight loss and dizziness in a 29-year-old man

Test Results

Results of appropriate studies return and show the following:

Serum:

Test (units) Result Results (SI Units)
9AM ACTH (ng/L) 880 pg/mL [194 pmol/L] Normal 10-60 pg/mL [2.2-13.2 pmol/L]
9 AM testosterone (nmol/L) 320 ng/dL [11.1 nmol/L] Normal 170-900 ng/dL [5.9-31.2 nmol/L]
Acetylcholine esterase levels Normal
Anti-adrenal cortex antibodies Negative
Ferritin level Normal
LH (U/L) 4.4 mU/mL [4.4U/L] 1.5-9.3 mU/mL [1.5-9.3 U/L]
FSH 5.9 mU/mL [5.9U/L] 4.4 mU/mL [4.4U/L] Normal 1.4-18 mU/mL [1.4-18 U/L]
Prolactin (mU/L) 12.3 ng/mL [535 pmol/L Normal or 3-31 ng/mL [130-1350 pmol/L]
Short Synacthen test (nmol/L) Flat cortisol response with baseline of 1.4 mcg/dL [39 nmol/L] and 30 minutes level of 1.9 mcg/dL [58 nmol/L] Normal 30 minutes cortisol above 15.5-18 mcg/dL [430-500 nmol/L] depending on local lab assay

Test (units) Result Results (SI Units)
Tuberculosis skin test (PPD) Negative
Plasma renin activity (upright) Renin: 600 ng/mL/hour [600 mcg/L/hr] Normal 2.9-10.8 ng/mL/hour 2.9-10.8 mcg/L/hour
CT scan of the adrenal glands Reported as bilateral subacute adrenal hemorrhage.