Jackson J A, Kleerekoper M, Parfitt A M
Ann Intern Med. 1986 Oct;105(4):543-5. doi: 10.7326/0003-4819-105-4-543.
A 66-year-old man presented with height loss, back pain due to an L4 vertebral compression deformity, and marked osteopenia shown by radial photon absorptiometry. The patient had small testes and a long history of infertility and impotence. Plasma testosterone was low (130 ng/dL; normal, 300 to 1000 ng/dL) with marked elevation of serum prolactin (590 ng/mL; normal, 0 to 15 ng/mL). High-resolution computed tomography showed an invasive pituitary macroadenoma with a secondary empty sella turcica. Bone histomorphometry showed low-normal trabecular bone volume with normal formation and resorption indices. The patient was treated with calcium carbonate supplements, testosterone replacement, and bromocriptine mesylate without subsequent progression of the osteoporosis. This first report of hyperprolactinemic hypogonadism in a man who presented with overt osteoporosis shows the importance of evaluating gonadal function in all osteoporotic men.
一名66岁男性，因L4椎体压缩性畸形出现身高降低、背痛，经桡骨光子吸收法检查显示有明显的骨质减少。该患者睾丸较小，有长期不育和阳痿病史。血浆睾酮水平较低（130 ng/dL；正常范围为300至1000 ng/dL），血清催乳素显著升高（590 ng/mL；正常范围为0至15 ng/mL）。高分辨率计算机断层扫描显示为侵袭性垂体大腺瘤并伴有继发性空蝶鞍。骨组织形态计量学显示小梁骨体积略低于正常，形成和吸收指数正常。该患者接受碳酸钙补充剂、睾酮替代治疗及甲磺酸溴隐亭治疗，骨质疏松未进一步发展。这是首例有明显骨质疏松的男性高催乳素血症性腺功能减退的报告，表明评估所有骨质疏松男性的性腺功能具有重要意义。
