Alsahwi Nassib, Blavo Delali, Karanchi Harsha
Department of Endocrinology and Metabolism, Louisiana State University Health Sciences Center Shreveport, Shreveport, Louisiana, USA.
BMJ Case Rep. 2016 Aug 5;2016:bcr2016216696. doi: 10.1136/bcr-2016-216696.
Sarcoidosis is a multisystem granulomatous disorder. The lungs are the principal organs affected, however, extrapulmonary involvement including disorders of the pituitary and thyroid glands has been reported but presentation with multiple endocrine manifestations is rare. We report the case of a 36-year-old African-American woman who presented with hypercalcaemia, abnormal thyroid function studies and secondary amenorrhoea. On workup including laboratory, radiological testing and biopsy she was diagnosed with sarcoidosis with multi-organ involvement. Endocrine manifestations included non-parathyroid hormone mediated hypercalcaemia related to sarcoidosis, thyroid involvement with sarcoidosis and hypothalamic-pituitary involvement with a sellar and suprasellar mass associated with secondary adrenal insufficiency, secondary hypogonadism, growth hormone deficiency and secondary hypothyroidism. We report to the best of our knowledge the first case of simultaneous multiple endocrine manifestations of sarcoidosis that included hypercalcaemia, hypopituitarism and sarcoidosis of the thyroid gland.
结节病是一种多系统肉芽肿性疾病。肺部是主要受累器官，然而，已有报道称结节病可累及肺外器官，包括垂体和甲状腺疾病，但以多种内分泌表现为特征的病例较为罕见。我们报告一例36岁非裔美国女性，她出现高钙血症、甲状腺功能检查异常及继发性闭经。经实验室检查、影像学检查及活检等评估，她被诊断为多器官受累的结节病。内分泌表现包括与结节病相关的非甲状旁腺激素介导的高钙血症、结节病累及甲状腺以及下丘脑 - 垂体受累，伴有鞍区和鞍上肿块，同时合并继发性肾上腺功能不全、继发性性腺功能减退、生长激素缺乏及继发性甲状腺功能减退。据我们所知，我们报告了首例结节病同时出现多种内分泌表现的病例，包括高钙血症、垂体功能减退及甲状腺结节病。
