Sacerdote Alan Scott, Mejía Javier O, Bahtiyar Gül, Salamon Oskar
Department of Medicine, Woodhull Medical Center, Brooklyn, NY, USA.
BMJ Case Rep. 2012 Jun 14;2012:bcr0620114417. doi: 10.1136/bcr.06.2011.4417.
The authors report a patient whose polycystic ovarian syndrome (PCOS) and increased calcitriol level were associated with neurocysticercosis (NCC), for which she refused standard therapy. Based upon a report on treatment with tamoxifen in murine cysticercosis,1 she was offered raloxifene. She began raloxifene 60 mg/day on 21 January 2010. On 17 March 2010 she was pregnant, and was terminated on 14 April 2010. MRI 26 April 2010 showed diminution in size, shrinkage and loss of viability in a number of the cysts. Total lesions fell from 37 to 33, 10 lesions shrunk, 5 resolved, 18 were unchanged, 4 enlarged and 1 new lesion developed. Concomitantly serum calcitriol fell from 81 to 41 pg/ml while 25-OH-vitamin D level fell from 34 to 30 ng/ml. Alteration of the hormonal milieu may reduce cestode burden in human NCC. The pregnancy on raloxifene, though unfortunate, supports the concept that NCC caused the PCOS. Serum calcitriol may be a useful biomarker for assessing disease activity in NCC.
作者报告了一名患者，其多囊卵巢综合征（PCOS）和骨化三醇水平升高与神经囊尾蚴病（NCC）相关，她拒绝了标准治疗。基于一篇关于他莫昔芬治疗小鼠囊尾蚴病的报告，1 她被给予雷洛昔芬。她于2010年1月21日开始服用雷洛昔芬，剂量为60毫克/天。2010年3月17日她怀孕了，并于2010年4月14日终止妊娠。2010年4月26日的MRI显示，一些囊肿的大小减小、萎缩且失去活性。总病灶数从37个降至33个，10个病灶缩小，5个病灶消失，18个病灶不变，4个病灶增大，1个新病灶出现。与此同时，血清骨化三醇从81 pg/ml降至41 pg/ml，而25-羟基维生素D水平从34 ng/ml降至30 ng/ml。激素环境的改变可能会减轻人类NCC中的绦虫负担。服用雷洛昔芬期间怀孕，虽然不幸，但支持了NCC导致PCOS的观点。血清骨化三醇可能是评估NCC疾病活动的有用生物标志物。
