Pedersen-Bjergaard U, Thorsteinsson B, Kirkegaard B C
Medicinsk afdeling F. Hillerød Sygehus.
Ugeskr Laeger. 1996 Mar 25;158(13):1818-22.
A review of the literature on pituitary function in haemochromatosis is presented. In morphological studies pituitary iron deposition, in particular in gonadotropic cells, has been demonstrated. In a number of case series, insufficiency of pituitary gonadotropic secretion with clinical hypogonadism was observed in 46% of the patients. Overt insufficiency of the other hormonal axes was infrequent. However, subclinical insufficiency of the growth hormone axis was present in 15%, of the lactotropic axis in 8%, of the thyroid axis in 4% and of the adrenocortical axis in 1.5% of the patients. Lactotropic, thyroid or adrenocortical insufficiency was usually associated with hypogonadism or growth hormone insufficiency. Investigation of pituitary function (in first line the gonadotropic and the somatotropic function) in patients with primary or secondary haemochromatosis is recommended on wide indications, in order to initiate relevant substitution therapy.
本文对血色素沉着症患者垂体功能的文献进行了综述。在形态学研究中,已证实垂体存在铁沉积,尤其是促性腺细胞中。在多个病例系列中,46%的患者观察到垂体促性腺激素分泌不足伴临床性腺功能减退。其他激素轴的明显功能不足并不常见。然而,15%的患者存在生长激素轴的亚临床功能不足,8%的患者存在催乳素轴功能不足,4%的患者存在甲状腺轴功能不足,1.5%的患者存在肾上腺皮质轴功能不足。催乳素、甲状腺或肾上腺皮质功能不足通常与性腺功能减退或生长激素不足相关。建议对原发性或继发性血色素沉着症患者在广泛适应证下进行垂体功能检查(首先是促性腺激素和生长激素功能),以便启动相关替代治疗。