García Rojas J F, Mangas Rojas A, Barba Chacón A, García Osle M, Zamora Madaria E
Departamento de Medicina Interna, Universidad de Cádiz.
Rev Clin Esp. 1991 Jan;188(1):37-40.
A patient suffering Cushing disease is presented in whom the administration of ciproheptadine, bromocriptine and sodium valproate in a single dose did not manage to control the clinical-biologic manifestations of the process. Combined treatment with 1.200 mg/day of sodium valproate and 15 mg/day of bromocriptine induced a complete clinical-biological remission, being arterial pressure the last parameter to normalize. The patient who has always refused to undergo surgery has stayed with this treatment for three years, maintaining remission and without appearance of side effects. On two occasions (after one and a half years and after two and half years) the transitory interruption of treatment induced in a few weeks an increase in plasma cortisol levels which again normalized after treatment was re-established. There were no clinical-biological data, pharmacological tests which permitted the prediction of these therapeutic results and therefore, the therapeutic response obtained is not indicative of any specific etiological subtype of Cushing disease.
本文报告了一名患有库欣病的患者,单次给予赛庚啶、溴隐亭和丙戊酸钠未能控制该疾病的临床生物学表现。联合使用每日1200毫克丙戊酸钠和每日15毫克溴隐亭进行治疗后,实现了完全的临床生物学缓解,动脉血压是最后恢复正常的参数。该患者一直拒绝接受手术,接受此治疗已达三年,维持了缓解状态且未出现副作用。有两次(分别在治疗一年半和两年半后),治疗的短暂中断在几周内导致血浆皮质醇水平升高,恢复治疗后又再次恢复正常。目前尚无临床生物学数据或药理学测试能够预测这些治疗结果,因此,所获得的治疗反应并不表明库欣病的任何特定病因亚型。