Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, Japan.
Department of Diagnostic Pathology, Faculty of Medicine, Kagawa University, Japan.
Intern Med. 2021 Apr 1;60(7):1047-1053. doi: 10.2169/internalmedicine.4663-20. Epub 2020 Nov 9.
It is quite rare that Cushing's disease shows acromegaly, and no pharmacotherapy has yet been discussed. A 21-year-old woman was diagnosed with Cushing's disease and underwent trans-sphenoidal surgery. Five years later, she was diagnosed with recurrent Cushing's disease and biochemical acromegaly because of elevated levels of serum growth hormone (GH), plasma insulin-like growth factor-1, plasma adrenocorticotropic hormone (ACTH), and the 24-hour urinary excretion of free cortisol. After treatment initiation with pasireotide-long-acting release (LAR), both the ACTH and GH declined. Our case is the first to show the efficacy of pasireotide-LAR in controlling both Cushing's disease and acromegaly.
库欣病并发肢端肥大症较为罕见,目前尚无相关药物治疗的报道。一名 21 岁女性患者被诊断为库欣病,并接受了经蝶窦手术治疗。5 年后,该患者因血清生长激素(GH)、血浆胰岛素样生长因子-1、血浆促肾上腺皮质激素(ACTH)以及 24 小时尿游离皮质醇水平升高,被诊断为库欣病复发和生化性肢端肥大症。给予帕瑞肽长效释放剂(LAR)治疗后,ACTH 和 GH 均下降。本例是首例报道帕瑞肽 LAR 可同时控制库欣病和肢端肥大症的病例。