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[原发性肾上腺皮质微小结节发育异常]

[Primary adrenocortical micronodular dysplasia].

作者信息

Dumić M, Ille J, Batinica S, Cacić M, Cvitanović M, Marinović B, Plavsić V, Lukenda M, Radica A

机构信息

Klinika za pedijatriju, KBC Rebro, Zagreb.

出版信息

Lijec Vjesn. 1999 Jan-Feb;121(1-2):22-6.

Abstract

Two girls (11 and 13 years old) with Cushing's syndrome due to primary adrenocortical micronodular dysplasia (PAMD) are presented. High plasma cortisol concentrations, elevated urinary free cortisol and 17-ketogenic steroids excretion, in addition to low or normal plasma adrenocorticotropic hormone (ACTH) levels pointed towards independent adrenal cortisol hypersecretion. In both girls bilateral adrenalectomy was performed, followed by replacement therapy with glucocorticoids and mineralocorticoids. Pathohistological findings of otherwise enlarged adrenal glands, showed characteristic small nodules measuring 1-2 mm, composed of cells resembling those of zona fasciculata, with abundant, clear cytoplasm. Our younger patient fulfilled the criteria of "Carney complex", because beside PAMD she has had the lentigines.

摘要

本文报告了两名患有原发性肾上腺皮质微小结节发育异常(PAMD)所致库欣综合征的女孩(分别为11岁和13岁)。高血浆皮质醇浓度、尿游离皮质醇升高以及17-生酮类固醇排泄增加,再加上血浆促肾上腺皮质激素(ACTH)水平低或正常,提示肾上腺皮质醇自主分泌过多。两名女孩均接受了双侧肾上腺切除术,随后进行糖皮质激素和盐皮质激素替代治疗。组织病理学检查发现,原本增大的肾上腺有特征性的1-2毫米小结节,由类似于束状带细胞的细胞组成,细胞质丰富且清晰。我们较年轻的患者符合“卡尼综合征”的标准,因为除了PAMD外,她还患有雀斑样痣。

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