Glucocorticoid deficiency 1

(Redirected from ACTH resistance) Further information: Glucocorticoid deficiency Medical condition

Glucocorticoid deficiency 1
Other names	FGD or GCCD

Glucocorticoid deficiency 1 is inherited in an autosomal recessive manner

Glucocorticoid deficiency 1 is an adrenocortical failure characterized by low levels of plasma cortisol produced by the adrenal gland despite high levels of plasma ACTH. This is an inherited disorder with several different causes which define the type.

FGD type 1 (FGD1 or GCCD1) is caused by mutations in the ACTH receptor (melanocortin 2 receptor; MC2R). FGD type 2 is caused by mutations in the MC2R accessory protein (MRAP). These two types account for 45% of all cases of FGD.

Some cases of FGD type 3 are caused by mutations in the steroidogenic acute regulatory protein (StAR), with similarity to the nonclassic form of lipoid congenital adrenal hyperplasia. In this case, a general impairment in not just adrenal steroid production, but gonadal steroid production can affect sexual development and fertility. The causes of other cases of FGD type 3 not due to StAR are currently unknown.

References

Clark AJ, McLoughlin L, Grossman A (October 1993). "Familial glucocorticoid deficiency associated with point mutation in the adrenocorticotropin receptor". The Lancet. 341 (8843): 461–462. doi:10.1016/0140-6736(93)90208-X. PMID 8094489. S2CID 11356360.
Tsigos C, Arai K, Hung W, Chrousos GP (November 1993). "Hereditary isolated glucocorticoid deficiency is associated with abnormalities of the adrenocorticotropin receptor gene". J. Clin. Invest. 92 (5): 2458–2461. doi:10.1172/JCI116853. PMC 288430. PMID 8227361.
Metherell LA, Chapple JP, Cooray S, David A, Becker C, Ruschendorf F, Naville D, Begeot M, Khoo B, Nurnberg P, Huebner A, Cheetham ME, Clark AJ (February 2005). "Mutations in MRAP, encoding a new interacting partner of the ACTH receptor, cause familial glucocorticoid deficiency type 2". Nature Genetics. 37 (2): 166–170. doi:10.1038/ng1501. PMID 15654338. S2CID 19104175.
Metherell LA, Naville D, Halaby G, Begeot M, Huebner A, Nürnberg G, Nürnberg P, Green J, Tomlinson JW, Krone NP, Lin L, Racine M, Berney DM, Achermann JC, Arlt W, Clark AJ (October 2009). "Nonclassic lipoid congenital adrenal hyperplasia masquerading as familial glucocorticoid deficiency". J. Clin. Endocrinol. Metab. 94 (10): 3865–3871. doi:10.1210/jc.2009-0467. PMC 2860769. PMID 19773404.

External links

GCCD1 Online Mendelian Inheritance in Man (OMIM): 202200
GCCD2 Online Mendelian Inheritance in Man (OMIM): 607398
GCCD3 Online Mendelian Inheritance in Man (OMIM): 609197

Classification	D ICD-10: E27.1 OMIM: 202200
External resources	Orphanet: 361

Adrenal gland disorder

Hyperfunction

Aldosterone	Hyperaldosteronism Primary aldosteronism Conn syndrome Bartter syndrome Glucocorticoid remediable aldosteronism AME Liddle's syndrome 17α CAH Pseudohypoaldosteronism
Cortisol	Cushing's syndrome Pseudo-Cushing's syndrome Steroid-induced osteoporosis
Sex hormones	21α CAH 11β CAH

Hypofunction

Aldosterone	Hypoaldosteronism 21α CAH 11β CAH
Cortisol	CAH Lipoid 3β 11β 17α 21α
Sex hormones	17α CAH Inborn errors of steroid metabolism
Adrenal insufficiency	Adrenal crisis Adrenalitis Xanthogranulomatous Addison's disease Waterhouse–Friderichsen syndrome

Inborn errors of steroid metabolism

Mevalonate
pathway

HMG-CoA lyase deficiency

To cholesterol

desmosterol path: Desmosterolosis

Steroids

Corticosteroid
(including CAH)

aldosterone: Glucocorticoid remediable aldosteronism

Sex steroid

To androgens	17α-Hydroxylase deficiency 17,20-Lyase deficiency Cytochrome b₅ deficiency 3β-Hydroxysteroid dehydrogenase deficiency 17β-Hydroxysteroid dehydrogenase deficiency 5α-reductase 2 deficiency Pseudovaginal perineoscrotal hypospadias
To estrogens	Aromatase deficiency Aromatase excess syndrome

Other

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