Strack T, Beyer J, Kann P, Brackertz D, Schrezenmeir J, Lehnert H
Schweiz Rundsch Med Prax. 1989 Nov 21;78(47):1323-6.
A 56-year-old female patient was admitted to our hospital because she was suffering from severe osteoporosis. The patient had experienced repeated spontaneous fractures for 1.5 years such as serial rib fractures, fractures of the sternum and most recently fracture of the neck of the femur after a minimal trauma. Histology revealed a low-turnover-osteoporosis. Subsequent radiologic examination showed extreme osteoporosis of the skeleton with numerous compression fractures of the vertebral bodies as the most outstanding finding. The bone histology and the relatively short history of spontaneous fractures led us to investigate endogenous hypercortisolism as a possible cause although clinical signs were absent. An attenuated diurnal variation of cortisol levels and lack of suppressibility of cortisol was found. Furthermore, magnetic resonance tomography showed a microadenoma of the pituitary gland. Computerized tomography of the adrenals was normal. Transsphenoidal surgery confirmed the tentative diagnosis and histological examination revealed a bilateral adenoma of the pituitary gland.
一名56岁女性患者因患有严重骨质疏松症入住我院。该患者在1.5年里反复出现自发性骨折，如多发性肋骨骨折、胸骨骨折，最近在受到轻微创伤后发生股骨颈骨折。组织学检查显示为低转换型骨质疏松症。随后的放射学检查显示骨骼极度骨质疏松，其中椎体大量压缩性骨折是最突出的表现。尽管没有临床症状，但鉴于骨组织学检查结果以及自发性骨折病史相对较短，我们对是否存在内源性皮质醇增多症作为可能病因进行了调查。结果发现皮质醇水平的昼夜变化减弱且皮质醇不受抑制。此外，磁共振断层扫描显示垂体有微腺瘤。肾上腺计算机断层扫描结果正常。经蝶窦手术证实了初步诊断，组织学检查显示为垂体双侧腺瘤。
