Ishikawa S, Kuratomi Y, Saito T
Endocrinol Jpn. 1980 Apr;27(2):257-63. doi: 10.1507/endocrj1954.27.257.
A woman with oat cell carcinoma of the lung showed the typical findings of the syndrome of inappropriate secretion of ADH initially during her hospital course. Ectopic production of ADH was indicated. The presence of ectopic production of ACTH was then suggested after the appearance of the elevation of plasma cortisol and ACTH which was not suppressed by dexamethasone administration. The laboratory findings of metabolic alkalosis and hypokalemia were also consistent with hyperadrenocorticism. In tumor tissue obtained by biopsy, ACTH and ADH were proven to be present by radioimmunoassay as well as nicotine-stimulated-neurophysin and estrogen-stimulated-neurophysin. This was a rare case in which the simultaneous production of ADH and ACTH was clinically diagnosed. It is suggested that the elevation of neurophysins in plasma is of value in the diagnosis of ectopic production of ADH.
一名患有肺燕麦细胞癌的女性在住院期间最初表现出抗利尿激素分泌不当综合征的典型症状。提示存在抗利尿激素的异位产生。在血浆皮质醇和促肾上腺皮质激素升高且地塞米松给药后未被抑制后，提示存在促肾上腺皮质激素的异位产生。代谢性碱中毒和低钾血症的实验室检查结果也与肾上腺皮质功能亢进相符。通过活检获得的肿瘤组织中，经放射免疫测定证实存在促肾上腺皮质激素和抗利尿激素，同时还存在尼古丁刺激的神经垂体素和雌激素刺激的神经垂体素。这是一例临床上诊断出同时产生抗利尿激素和促肾上腺皮质激素的罕见病例。提示血浆中神经垂体素的升高对诊断抗利尿激素的异位产生有价值。
