Martul P, Loridan L, Igea J, Luzuriaga C
An Esp Pediatr. 1978 Mar;11(3):213-8.
A case of Cushing's disease in a ten year old girl with bilateral diffuse hyperplasia of the adrenal cortex and postoperative enlargment of the sella turcica is presented. The administration of dexamethasone elicited a paradoxical response with a clear elevation of the already high excretion of 17-hydroxycorticoids. The possible mechanisms for this previously described, but infrequent, response to dexamethasone are discussed. It is concluded that: 1) Interpretation of the classical dexamethasone suppression test can occasionally be misleading; and 2) Periodic hormonogenesis may account for this type of paradoxical response.
本文报告一例10岁患库欣病的女孩,其双侧肾上腺皮质弥漫性增生,术后蝶鞍增大。给予地塞米松后出现矛盾反应,17-羟皮质类固醇排泄量本已很高,用药后明显升高。文中讨论了这种先前已有描述但并不常见的对地塞米松反应的可能机制。得出以下结论:1)经典地塞米松抑制试验的解释偶尔可能会产生误导;2)周期性激素生成可能是这种矛盾反应的原因。