由于垂体脑梗塞而导致的低垂体症的Graves病
Chiara Mura1, Rebecca Sonnino1, Laura Crispino1
1UOC Endocrinologia e Diabetologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Roma.
Endocrine, metabolic & immune disorders drug targets
|July 12, 2024
概括
这一案例凸显了中央甲状腺功能低下症和格雷夫斯病的罕见共存. 在这种情况下,甲状腺刺激激素 (TSH) 监测是不可靠的,需要仔细管理甲状腺激素水平.
科学领域:
- 内分泌学 在内分泌学.
- 内部医学 内部医学
- 生殖医学 生殖医学
背景情况:
- 中枢甲状腺功能低下症和自身免疫性甲状腺功能过高症是不同的内分泌疾病.
- 它们的同时发生带来了诊断和治疗方面的挑战.
- 仔细监测激素水平对于管理这些疾病至关重要.
研究的目的:
- 报告一个独特的中央甲状腺功能低下症和格雷夫斯病共存的病例.
- 为了说明诊断的复杂性和管理策略.
- 强调甲状腺刺激激素 (TSH) 在监测疾病进展方面的局限性.
主要方法:
- 这里介绍了一个41岁的女性患者的病例报告.
- 患者经历了垂体脑梗塞,导致前部泛垂体和中央甲状腺功能低下.
- 格雷夫斯病随后发展,需要与甲状腺功能低下症治疗一起进行谨慎的管理.
主要成果:
- 该患者因中央甲状腺功能低下症而接受激素替代疗法治疗.
- 格雷夫斯病被诊断并用甲基马治疗.
- 由于中央甲状腺功能低下症,甲状腺刺激激素 (TSH) 水平仍然受到抑制,使监测变得困难.
- 管理依赖于自由甲状腺激素水平和抗体标位.
结论:
- 中枢甲状腺功能低下症和自身免疫性甲状腺功能障碍症 (格雷夫病) 的共存是罕见的,并且在临床上具有挑战性.
- 在这种情况下,甲状腺刺激激素 (TSH) 是疾病进展的不可靠标志物.
- 有效的管理需要密切监测自由甲状腺激素水平和临床状态.
相关概念视频
01:27Major Hormones and Their Functions
366
Hormones, the biochemical messengers produced by endocrine glands, are pivotal in regulating bodily functions and maintaining homeostasis. Each hormone's balance is crucial; imbalances can lead to significant physiological disruptions. Major hormones include oxytocin, cortisol, epinephrine, estrogen, testosterone, thyroxine, growth hormone, insulin, and glucagon.
Oxytocin, produced in the hypothalamus and released by the pituitary gland, plays a role in social bonding, childbirth, and...
Oxytocin, produced in the hypothalamus and released by the pituitary gland, plays a role in social bonding, childbirth, and...
366
01:27Adrenal Gland Disorders
1.5K
Adrenal gland disorders manifest when the production of adrenal hormones deviates from the norm, resulting in either excessive or insufficient concentrations.
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...
1.5K
00:59The Parathyroid Glands
2.0K
The two pairs of parathyroid glands embedded within the posterior surface of the thyroid gland are restricted by a dense capsule around them. These glands comprise two distinct cell populations—parathyroid oxyphil and parathyroid principal cells- pivotal in calcium homeostasis.
Oxyphil cells, whose functions remain elusive, emerge during late puberty, adding a layer of complexity to the parathyroid gland's intricacies. In contrast, principal parathyroid cells undertake a vital role by...
Oxyphil cells, whose functions remain elusive, emerge during late puberty, adding a layer of complexity to the parathyroid gland's intricacies. In contrast, principal parathyroid cells undertake a vital role by...
2.0K
01:17Gastritis-II: Pathophysiology
312
Gastritis is marked by disruption of the mucosal barrier that usually protects the stomach tissue from digestive juices and manifests in acute and chronic forms.
In acute gastritis, the gastric mucosa becomes swollen and red and undergoes superficial erosion. Superficial ulceration may lead to bleeding.
In chronic gastritis, persistent or repeated insults lead to chronic inflammatory changes and, eventually, thinning or atrophy of the gastric tissue.
Gastritis can stem from various causes, each...
In acute gastritis, the gastric mucosa becomes swollen and red and undergoes superficial erosion. Superficial ulceration may lead to bleeding.
In chronic gastritis, persistent or repeated insults lead to chronic inflammatory changes and, eventually, thinning or atrophy of the gastric tissue.
Gastritis can stem from various causes, each...
312
01:20Synthesis and Regulation of Thyroid Hormones
4.5K
Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...
4.5K
01:15Hypoglycemia and Glucagon
254
Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
254