一例肢端肥大症合并格雷夫斯病。内源性促甲状腺激素释放激素的可能作用及溴隐亭对生长激素和促甲状腺激素分泌的影响。

A case of acromegaly associated with Graves' disease. A possible role of endogenous TRH and an effect of bromocriptine on GH and TSH secretion.

作者信息

Demura R, Demura H, Odagiri E, Shizume K

出版信息

Endocrinol Jpn. 1984 Dec;31(6):801-7. doi: 10.1507/endocrj1954.31.801.

DOI:10.1507/endocrj1954.31.801

Abstract

A 44-year-old man subjected to Hardy's operation for a treatment of acromegaly developed hyperthyroidism right after surgery. He had a normal thyroid function with a slightly suppressed TSH response to TRH before operation. Sudden onset of hyperthyroidism after surgery and suppressed TSH were compatible with Graves' disease. Hyperthyroidism was effectively treated with propylthiouracil (PTU) with slightly increased basal TSH level and normal response of TSH to TRH. Plasma GH level also increased after he attained euthyroidism, but inappropriate GH response to TRH persisted. It is suggested that increased endogenous TRH stimulated both TSH and GH release, but inappropriate GH response to TRH occurred irrespective of endogenous hypothalamic TRH. Bromocriptine, 5.0 mg/day, suppressed plasma GH level to a normal range with a concomitant suppression of PRL and TSH, both basal levels and responses to TRH.

摘要

一名44岁男性因肢端肥大症接受了哈代手术，术后随即出现甲状腺功能亢进。术前他的甲状腺功能正常，对促甲状腺激素释放激素（TRH）的促甲状腺激素（TSH）反应略有抑制。术后突然发生甲状腺功能亢进且TSH受抑制，符合格雷夫斯病。丙硫氧嘧啶（PTU）有效治疗了甲状腺功能亢进，基础TSH水平略有升高，TSH对TRH的反应正常。甲状腺功能正常后血浆生长激素（GH）水平也升高，但对TRH的GH反应仍不适当。提示内源性TRH增加刺激了TSH和GH释放，但无论内源性下丘脑TRH如何，均出现对TRH的GH反应不适当。每日5.0毫克溴隐亭将血浆GH水平抑制至正常范围，同时抑制了催乳素（PRL）和TSH，包括基础水平及对TRH的反应。