肢端肥大症与甲状腺功能亢进症相关的糖尿病。

Acromegaly and diabetes mellitus associated with hyperthyroidism.

作者信息

Deng Datong, Luo Li, Chen Mingwei, Xu Min, Wang Youmin

出版信息

Neuro Endocrinol Lett. 2014;35(3):171-4.

Abstract

A 66-year-old woman with acromegaly and diabetes mellitus as well as primary hyperthyroidism is described. Serum GH Levels were inappprpriately high.MRI revealed an enlarged sella turcica with intrasellar mass. Her HbAlc was 12.2% and fasting blood glucose 8.89 mmol/l. Thyroid hormone levels in serum and thyroidal radioiodine uptake values were elevated, while TSH measurements in serum were low. Anti TPO antibodies were negative, TSH receptor antibodies were normal. Thyrotoxicosis as the first presenting illness in acromegaly was particulary uncommon. An ultrasound thyroid scan showed a multinodular goiter. Histology of the pituitary lesion showed a typical eosinophilic adenoma which only secreted GH when tested with specific immunostain. Post-operatively, the patient's clinical conditions improved, however, secondary hypoadrenalism appeared.

摘要

本文描述了一位66岁患有肢端肥大症、糖尿病以及原发性甲状腺功能亢进的女性患者。血清生长激素（GH）水平异常升高。磁共振成像（MRI）显示蝶鞍增大并伴有鞍内肿块。她的糖化血红蛋白（HbAlc）为12.2%，空腹血糖为8.89毫摩尔/升。血清甲状腺激素水平和甲状腺放射性碘摄取值升高，而血清促甲状腺激素（TSH）测量值较低。抗甲状腺过氧化物酶（TPO）抗体为阴性，促甲状腺激素受体抗体正常。甲状腺毒症作为肢端肥大症的首发疾病尤为罕见。甲状腺超声扫描显示为结节性甲状腺肿。垂体病变的组织学检查显示为典型的嗜酸性腺瘤，经特异性免疫染色检测仅分泌生长激素。术后，患者的临床状况有所改善，但出现了继发性肾上腺皮质功能减退。