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一个异胎ACTH产生瘤的病例与上腺收缩在osilodrostat管理期间
Fumikazu Sawabe1, Ryo Hayafusa1, Rieko Kosugi1
1Center for Diabetes, Endocrinology and Metabolism, Shizuoka General Hospital, Shizuoka City, 420-8527, Japan.
JCEM case reports
|January 29, 2024
概括
在患有小细胞肺癌的患者中,奥西洛德洛斯塔特有效地控制了异胎ACTH产生库希综合征. 治疗导致皮质醇抑制和显著的上腺缩,可能允许降低剂量.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 异位上腺皮质激素 (ACTH) 分泌的瘤会导致依赖于ACTH的库希综合征.
- 无法切除的瘤的医疗管理包括 metyrapone,mitotane 和 ketoconazole.
- 为了有效控制高皮质醇症,需要新的治疗选择.
研究的目的:
- 报告一个异胎ACTH产生库希综合征的病例,用osilodrostat治疗.
- 评估奥西洛德罗斯塔特在治疗高皮质醇症及其对上腺体大小的影响中的有效性.
主要方法:
- 一名68岁的男性患有小细胞肺癌和子宫外ACTH综合征接受了治疗.
- 最初的米他治疗不足.
- 开始使用奥西洛德罗斯塔特,并逐渐减少美西拉,并监测上腺的反应.
主要成果:
- 奥西洛德罗斯塔特实现了血液皮质醇水平的完全抑制.
- 患者在治疗时经历了上腺的显著收缩.
- 这些发现表明,在继续治疗时,可能会降低奥西洛德罗斯塔特剂量.
结论:
- 奥西洛德罗斯塔特是一种有前途的治疗外宫ACTH产生库辛综合征.
- 这种药物在抑制皮质醇方面表现出有效性,并诱导上腺激发.
- 上腺缩可能表明有利的长期治疗概况和剂量调整的可能性.
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