与库辛病的手术缓解相关的自身免疫性疾病:一项队列研究
Dennis Delasi Nyanyo1, Masaaki Mikamoto2, Francesca Galbiati1
1The Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (D.D.N., F.G., I.R., K.B., L.B.N.).
Annals of internal medicine
|February 19, 2024
概括
与非功能性垂体腺瘤 (NFPAs) 患者相比,缓解期的库辛病 (CD) 患者患自身免疫性疾病的风险更高. 患有自身免疫性疾病的家族史可能会增加这种风险.
科学领域:
- 内分泌学 在内分泌学.
- 免疫学 免疫学 免疫学
- 在瘤学瘤学.
背景情况:
- 已知葡萄糖皮质类药物可以抑制炎症.
- 库辛病 (CD) 缓解后的自身免疫性疾病的发展尚未得到充分证实.
- 了解这种联系对于患者管理至关重要.
研究的目的:
- 为了比较手术缓解后CD患者自身免疫性疾病的发病率与非功能性垂体腺瘤 (NFPA) 患者.
- 为了确定后缓解CD患者自身免疫疾病的临床表现和风险因素.
主要方法:
- 追溯匹配的队列分析.
- 包括接受手术的CD和NFPA患者.
- 使用唾液皮质醇,24小时尿液自由皮质醇 (UFC) 和甲抑制试验评估高皮质素血症.
主要成果:
- 与NFPA患者 (1.6%) 相比,CD患者 (10.4%) 的新发自免疫性疾病的累积发病率在3年内更高.
- 癌症患者的术后上腺功能不充分和血清皮质醇水平较低.
- 较低的手术前UFC比率和较高的自身免疫性疾病家族史在患有自身免疫性疾病的CD患者中被注意到.
结论:
- 与NFPA相比,CD的手术缓解与自身免疫性疾病的发病率增加有关.
- 自身免疫性疾病的家族病史是潜在的危险因素.
- 手术后的上腺功能衰竭可能会成为自身免疫性疾病发展的触发因素.
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