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[家族性舞蹈病-棘红细胞增多症中下丘脑-垂体激素分泌紊乱]

[Disturbance of hypothalamic-pituitary hormone secretion in familial chorea-acanthocytosis].

作者信息

Terao S, Sobue G, Takahashi M, Miura N, Mitsuma T, Takeda A, Sakakibara T

机构信息

Fourth Department of Internal Medicine, Aichi Medical University, Japan.

出版信息

No To Shinkei. 1995 Jan;47(1):57-61.

PMID:7669403
Abstract

An endocrinological study was performed dopaminergic regulation of the hypothalamic-pituitary axis of 3 patients with familial chorea-acanthocytosis (females, 38 to 47 years of age). All 3 patients exhibited low basal levels of triiodo-thyronine (T3), and 2 patients had a slightly elevated baseline plasma prolactin (PRL) level. The patients had a delayed plasma thyroid stimulating hormone (TSH) response and plasma PRL excessive response to thyrotropin releasing hormone (TRH), and a low plasma growth hormone releasing hormone (GRF) response to L-dopa. These TSH, PRL and GRF responses represent a secretion pattern due to a hypothalamic disorder, suggesting impaired regulation of hormone secretion by the dopaminergic system, primarily in the hypothalamus. In addition, an increased growth hormone (GH) response secretion following TRH (paradoxical response) was observed in 2 patients, suggesting that the pituitary was also involved. An oral glucose tolerance test (75g-OGTT) revealed a diabetic pattern in all 3 patients, indicating frequent association with impaired glucose tolerance.

摘要

对3例家族性舞蹈病-棘红细胞增多症患者(女性,38至47岁)的下丘脑-垂体轴多巴胺能调节进行了内分泌学研究。所有3例患者的基础三碘甲状腺原氨酸(T3)水平均较低,2例患者的基线血浆催乳素(PRL)水平略有升高。患者对促甲状腺激素释放激素(TRH)的血浆促甲状腺激素(TSH)反应延迟,血浆PRL反应过度,对左旋多巴的血浆生长激素释放激素(GRF)反应较低。这些TSH、PRL和GRF反应代表了由于下丘脑疾病导致的分泌模式,提示多巴胺能系统对激素分泌的调节受损,主要在下丘脑。此外,2例患者在TRH后观察到生长激素(GH)反应性分泌增加(反常反应),提示垂体也受累。口服葡萄糖耐量试验(75g-OGTT)显示所有3例患者均呈糖尿病模式,表明常伴有葡萄糖耐量受损。

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