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伪赤道巨症-内分泌诊所中的一个具有挑战性的实体:系统性审查
Pedro Marques1,2, Inês Sapinho1, Márta Korbonits3
1Pituitary Tumor Unit, Endocrinology Department, Hospital CUF Descobertas, Lisbon, Portugal.
Clinical endocrinology
|March 29, 2024
概括
伪壮症模仿了壮症,没有生长激素 (GH) 或类似胰岛素的生长因子-1 (IGF-1) 过量. 帕希德尔摩皮质症和胰岛素介导的伪壮症是常见的模仿症,需要仔细的GH/IGF-1评估来排除真正的壮症.
科学领域:
- 内分泌学 在内分泌学.
- 内部医学 内部医学
背景情况:
- 伪壮症呈现出类似壮症的特征,但缺乏生长激素 (GH) 或类似胰岛素的生长因子-1 (IGF-1) 过量.
- 临床怀疑壮症需要与模仿该疾病的疾病进行区分.
研究的目的:
- 审查和分析已发表的伪壮症病例.
- 为了确定常见的 pseudoacromegaly 的原因和诊断方法.
主要方法:
- 对符合特定诊断标准的伪壮病病例进行PubMed/Medline系统审查.
- 纳入标准:表现暗示缩症,不包括GH/IGF-1过量,证实伪缩症诊断.
- 数据提取和收集的案例信息的集体分析.
主要成果:
- 审查了76例病例;最常见的病例是帕希德尔摩皮质静止症 (47%) 和胰岛素介导的伪增大病 (IMP) (24%).
- 共有的特征包括形面部 (75%) 和形扩大 (80%).
- GH/IGF-1的评估有所不同;两个测试是最常见的排除 (53%). 在11%的MRI中发现了垂体附带瘤.
结论:
- 伪壮症是一种诊断挑战,通常需要内分泌学家的专业知识.
- 包皮皮质静止症和IMP是壮病的关键差异诊断.
- 精确的GH/IGF-1测试至关重要;仔细评估垂体发现可以防止不必要的手术.
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