低垂体症
Claire E Higham1, Gudmundur Johannsson2, Stephen M Shalet1
1Department of Endocrinology, Christie Hospital NHS Foundation Trust, Manchester, UK; Centre for Endocrinology and Diabetes, Institute of Human Development, Faculty of Medical and Human Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
Lancet (London, England)
|April 5, 2016
まとめ
下垂体ホルモンの欠乏症である低垂体症は,特にコルチゾール欠乏症による死亡リスクを高めます. 早期診断とホルモン補充療法が この状態の管理に不可欠です
科学分野:
- 内分泌学
- 内科 医学
背景:
- 低垂体症は,一つまたは複数の垂体ホルモンの欠乏を伴う.
- アドレノコルチノトロプホルモン (ACTH) 欠乏によるコルチゾール欠乏症は,下垂体症における過剰死亡の主要な危険因子である.
- 大人の場合,下垂体腺腫,手術,放射線療法は一般的な原因です.
研究 の 目的:
- 垂直下垂体症の総合的な概要を提示する.
- 診断方法と管理戦略の概要
- ホルモン補充療法の 重要な側面を強調します
主な方法:
- 診断には,ある種のホルモン欠乏症に対する 初期血液採取が含まれます.
- 動的刺激検査は,ACTH,成長ホルモン,抗利尿ホルモンの欠乏を評価するために通常必要である.
- 徐々に進化する形態では,定期的な下垂体機能の再評価が必要である.
主要な成果:
- 代用療法にはチロキシン,ヒドロコルチゾン,性ステロイド,成長ホルモン,デスマプレシンが含まれます.
- 急性発症では,コルチゾール欠乏症の補充が優先されます.
- 治療は,小児から成人への移行と妊娠中に変更する必要があります.
結論:
- 低垂体症の効果的な治療には 正確な診断と間に合ったホルモン補充が必要です
- 最適な患者の治療結果を得るために,厳密なモニタリングと,個別化された治療調整が不可欠です.
- 臨床医は様々な原因と 管理のニュアンスを理解することが重要です
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