Lawrence A M, Gordon D L, Hagen T C, Schwartz M A
Arch Intern Med. 1977 Sep;137(9):1134-7.
Pituitary apoplexy in acromegaly is an uncommon event having been recorded approximately 30 times in the English literature. This report records two additional cases that included growth hormone measurements and an assessment of pituitary function. The apoplectic event developed spontaneously in one, and in the other it developed within two weeks of completing a course of radiotherapy to the pituitary gland. Autocure of the acromegaly was apparent. Basal levels of growth hormone were in the normal range but failed to change with provocative stimuli. Luteinizing hormone and follicle-stimulating hormone titers, although detectable, were inappropriately low for the degree of hypogonadism. Pituitary insufficiency was associated with a significant thyroid-stimulating hormone response to protirelin in one patient tested. It is suggested that these experiments of nature lend credence to the proposal that the hypothalamus may play a critical role in the perpetuation of growth hormone hypersecretion in some patients with acromegaly.
肢端肥大症患者发生垂体卒中是一种罕见事件，英文文献中约有30例相关记载。本报告记录了另外两例病例，包括生长激素测定及垂体功能评估。其中一例垂体卒中为自发发生，另一例在完成垂体放疗疗程后两周内出现。肢端肥大症自行缓解明显。生长激素基础水平在正常范围内，但对激发刺激无变化。黄体生成素和促卵泡激素水平虽可检测到，但与性腺功能减退程度不相称地偏低。在接受检测的一名患者中，垂体功能不全与对普罗瑞林的促甲状腺激素显著反应相关。有人提出，这些自然实验支持了下丘脑可能在某些肢端肥大症患者生长激素分泌过多持续存在中起关键作用这一观点。
