Birkenhäger J C, Upton G V, Seldenrath H J, Krieger D T, Tashjian A H
Acta Endocrinol (Copenh). 1976 Oct;83(2):280-92. doi: 10.1530/acta.0.0830280.
A 45-year-old women had medullary tyroid carcinoma associated with Cushing's syndrome and galactorrhoea. Elevated plasma immunoreactive ACTH and cortisol were partially suppressed by intravenous dexamethasone, appreciably raised by lysine vasopressin, and urinary excretion of 17-oxogenic steroids slightly elevated by metyrapone. A large arterio-venous increase in plasma corticotrophin releasing factor-like activity across the thyroid gland was observed and tumour tissue contained corticotrophin releasing factor-like activity. Biologically active ACTH was not detected in tumour extracts before incubation with trypsin, but after trypsinization a value of 3.2 mU per gram was obtained. Arterial plasma contained biologically active ACTH (1.5 mU/100 ml) prior to trypsinization. Venous effluent from the thyroid gland contained biologically active (9.6 mU/100 ml) and immunoreactive ACTH (970 pg/ml) before trypsinization. Tumour extracts also contained prolactin production-stimulating activity. These findings can explain the Cushing's syndrome and the galactorrhoea both of which disappeared completely after thyroidectomy.
一名45岁女性患有甲状腺髓样癌，同时伴有库欣综合征和溢乳。静脉注射地塞米松可部分抑制血浆免疫反应性促肾上腺皮质激素（ACTH）和皮质醇升高，赖氨酸加压素可使其显著升高，甲吡酮可使17-氧代类固醇的尿排泄量略有升高。观察到甲状腺两侧血浆促肾上腺皮质激素释放因子样活性有较大的动静脉差异，且肿瘤组织含有促肾上腺皮质激素释放因子样活性。在与胰蛋白酶孵育前，肿瘤提取物中未检测到生物活性ACTH，但胰蛋白酶处理后，每克获得3.2 mU的值。胰蛋白酶处理前，动脉血浆中含有生物活性ACTH（1.5 mU/100 ml）。甲状腺静脉流出液在胰蛋白酶处理前含有生物活性ACTH（9.6 mU/100 ml）和免疫反应性ACTH（970 pg/ml）。肿瘤提取物还含有催乳素分泌刺激活性。这些发现可以解释库欣综合征和溢乳现象，甲状腺切除术后两者均完全消失。
