ISOLATED ADRENOCORTICOTROPIC HORMONE DEFICIENCY ASSOCIATED WITH GROWTH-HORMONE DEFICIENCY AND EMPTY SELLA

被引：4

作者：

HATAZOE, T

MURAKAMI, Y

UMAKI, I

SOHMIYA, M

HU, HY

KATO, Y

机构：

[1] The First Division, Department of Medicine, Shimane Medical University, Izumo

来源：

INTERNAL MEDICINE | 1995年 / 34卷 / 07期

关键词：

RECOMBINANT HUMAN GROWTH HORMONE; REPLACEMENT; BODY COMPOSITION; CORTICOTROPIN-RELEASING HORMONE (CRH);

D O I：

10.2169/internalmedicine.34.688

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

A 38-year-old man had an acute onset of consciousness loss, pyrexia and hyponatremia, Plasma Adrenocorticotropic Hormone (ACTH) and cortisol levels were low, Plasma ACTH failed to respond to corticotropin-releasing hormone (CRH) and insulin-induced hypoglycemia whereas i.m. injection of ACTH-Z raised plasma cortisol, Plasma insulin-like growth factor-I (IGF-I) and urine growth hormone (GH) concentrations were also low and plasma thyroid-stimulating hormone (TSH) level was father elevated, Plasma IGF-I and TSH levels were not completely normalized by glucocorticoid (GC) replacement alone although plasma GH responses to pharmacological stimuli were normalized, The GC replacement in combination with daily s.c. injection of recombinant human GH (rhGH) not only normalized plasma IGF-I and IGFBP-3 levels, but also further lowered the plasma TSH level, possibly due to an increased T-4/T-3 conversion, which resulted in a beneficial change in body composition.

引用

页码：688 / 691

页数：4

共 10 条

[1]

Sternberg A., Shechter F.R., Segal H.I., True pituitary Addison's disease: a pituitary unitropic deficiency (fifteen-year follow up), J Clin Endocrinol, 14, (1954)

[2]

Hashimoto K., Nishioka T., Iyota K., Et al., Hyperresponsiveness of TSH and prolactin and impaired responsiveness of GH in Japanese patients with isolated ACTH deficiency, Folia Endocrinol, 68, (1992)

[3]

Yamamoto T., Fukuyama J., Hasegawa K., Sugiura M., Isolated corticotropin deficiency in adults, Arch Intern Med, 152, (1992)

[4]

Sohmiya M., Kato Y., Renal clearance, metabolic clearance rate and half-life of human growth hormone in young and aged subjects, J Clin Endocrinol Metab, 75, (1992)

[5]

Hu H.-Y., Yamamoto H., Sohmiya M., Abe T., Murakami Y., Kato Y., Body composition assessed by biochemical impedance analysis (BIA) and the correlation with plasma insulin-like growth factor I (IGF-I) in normal Japanese subjects and patients with acromegaly and GH deficiency, Endocr J, 41, (1994)

[6]

Adams E.F., Brajkovich I.E., Mashiter K., Growth hormone and prolactin secretion by dispersed cell cultures of human pituitary adenomas: long-term effects of hydrocortisone, estradiol, insulin, 3,5,3'-triiodothyronine and thyroxine, J Clin Endocrinol Metab, 53, (1981)

[7]

Giustina A., Romanelli G., Candrina R., Giustina G., Growth hormone deficiency in patients with idiopathic adrenocorticotropin deficiency resolves during glucocorticoid replacement, J Clin Endocrinol Metab, 68, (1989)

[8]

Pirazzoli P., Cacciari E., Mandini, Et al., Growth and thyroid function in children treated with growth hormone, J Pediatr, 121, (1992)

[9]

Whitehead H.M., Boreham C., Mclrash E.M., Et al., Growth hormone treatment of adults with growth hormone deficiency: results of a 13-month placebo controlled cross over study, Clin Endocrinol, 36, (1992)

[10]

Salomon F., Cuneo R.C., Hesp R., Sonksen P.H., The effects of treatment with recombinant human growth hormone on body composition and metabolism in adults with growth hormone deficiency, N Engl J Med, 321, (1989)

← 1 →