伴有反复发作的巨大卡麦角林抵抗性泌乳素瘤的抗利尿激素分泌不当综合征。
Syndrome of inappropriate antidiuretic hormone with recurrent giant cabergoline-resistant prolactinoma.
机构信息
Diabetes, Endocrinology and Clinical Immunology, Hyogo Medical University, Nishinomiya, Hyogo, Japan
General Medicine, Hyogo Ika Daigaku Sasayama Iryo Center, Sasayama, Hyogo, Japan.
出版信息
BMJ Case Rep. 2023 Sep 28;16(9):e255422. doi: 10.1136/bcr-2023-255422.
A macro pituitary tumour or giant pituitary tumour is regarded as a rare causal factor in syndrome of inappropriate antidiuretic hormone (SIADH) cases. Previous reports have presented findings showing that blood flow insufficiency related to stress caused by an obstructive mass may lead to inappropriate secretion of arginine vasopressin. On the other hand, prolactin is known to influence water metabolism, and several cases of a macroprolactinoma or giant prolactinoma (PRLoma) in patients with SIADH have been reported. Nevertheless, few studies have examined such a relationship with SIADH and discussion of pathophysiological factors has been limited. The present report provides details of an elderly patient with SIADH in a chronic giant PRLoma. Of note, exacerbation of prolactin level accompanied the occurrence of SIADH. Findings obtained in this case suggest the possibility of development of SIADH in PRLoma cases due to more than only the effect of the mass.
大垂体瘤或巨大垂体瘤被认为是抗利尿激素不适当分泌综合征（SIADH）病例中罕见的病因。先前的报告表明，与阻塞性肿块引起的应激相关的血流不足可能导致精氨酸血管加压素的不适当分泌。另一方面，催乳素已知会影响水代谢，并且已经报道了几例患有 SIADH 的大催乳素瘤或巨大催乳素瘤（PRLoma）的病例。然而，很少有研究检查过这种与 SIADH 的关系，并且对病理生理因素的讨论也受到限制。本报告提供了一例患有慢性巨大催乳素瘤的 SIADH 老年患者的详细信息。值得注意的是，催乳素水平的恶化伴随着 SIADH 的发生。该病例的结果表明，PRLoma 病例中发生 SIADH 的可能性不仅与肿块的影响有关。
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