Cioni K, Pantaleoni M, Toschi E, Frank G, Marrama P, Velardo A
Cattedra e Servizio di Endocrinologia, Università degli Studi di Modena.
Minerva Endocrinol. 1993 Sep;18(3):139-41.
A 41 year old woman affected by Cushing's disease underwent hemi-hypophysectomy with removal of an ACTH secreting microadenoma. Forty days later, when normal ACTH, cortisol plasma levels and urinary cortisol levels were restored, features of primary autoimmune hypothyroidism developed. While cortisol levels were elevated serum thyroid hormone levels were normal, serum hormone TSH was at the upper limit of the normal range and serum antimicrosomal antibodies were slightly elevated. It is likely that hypothyroidism already present before surgery was not clinically evident due to the immunosuppressive effect of high cortisol levels. The need to assess thyroid function in patient with hypercortisolism is emphasized with the aim to identify the possible onset of autoimmune thyroid disease when cortisol levels are normalized.
一名患有库欣病的41岁女性接受了半垂体切除术，切除了分泌促肾上腺皮质激素（ACTH）的微腺瘤。40天后，当ACTH、血浆皮质醇水平和尿皮质醇水平恢复正常时，原发性自身免疫性甲状腺功能减退的症状出现了。虽然皮质醇水平升高，但血清甲状腺激素水平正常，血清促甲状腺激素（TSH）处于正常范围上限，血清抗微粒体抗体略有升高。很可能术前就已存在的甲状腺功能减退由于高皮质醇水平的免疫抑制作用而未在临床上显现出来。强调了对皮质醇增多症患者进行甲状腺功能评估的必要性，目的是在皮质醇水平恢复正常时识别自身免疫性甲状腺疾病可能的发病情况。
