Koga T, Abe T, Noriyuki H, Iwatani N, Otsuka T
Department of Neurology, Otemachi Hospital.
Intern Med. 1998 Aug;37(8):674-7. doi: 10.2169/internalmedicine.37.674.
A 59-year-old female with 20-year history of slowly progressing muscle atrophy and sensory disturbance of upper extremities showed short stature, scoliosis, hunger type of sensory dissociation of the upper extremities and pyramidal tract sign of the lower extremities. Magnetic resonance imaging (MRI) clarified hypoplasia of the anterior pituitary lobe, Arnold-Chiari malformation and cervical syringomyelia. Insulin and arginine stimulating tests revealed partial type of isolated growth hormone (GH) deficiency but GH gene analysis detected no defects of GH genes. It was considered to be a rare case of non-hereditary hypopituitarism with Chiari malformation and syringomyelia not associated with perinatal injury, namely a midline anomaly syndrome.
一名59岁女性,有20年缓慢进展的上肢肌肉萎缩和感觉障碍病史,表现为身材矮小、脊柱侧弯、上肢饥饿型感觉分离以及下肢锥体束征。磁共振成像(MRI)显示垂体前叶发育不全、阿诺德-基亚里畸形和颈段脊髓空洞症。胰岛素和精氨酸刺激试验显示为部分型孤立性生长激素(GH)缺乏,但GH基因分析未检测到GH基因缺陷。这被认为是一例罕见的非遗传性垂体功能减退症,伴有阿诺德-基亚里畸形和脊髓空洞症,与围产期损伤无关,即中线异常综合征。