压力诱导的高甲状腺血症模仿垂体病理:一个诊断挑战
Kanika Vats1, Roshan Kurian John2, Sindhu Ann Korah3
1Directorate of Research and Innovation, Emirates Classification Society (TASNEEF), Abu Dhabi, ARE.
Cureus
|July 14, 2025
概括
压力会导致益乳素水平升高 (超益乳素血症),即使有视力变化等令人担忧的症状. 这一案例凸显了在诊断时考虑心理压力的重要性,避免过度诊断下垂体问题的重要性.
科学领域:
- 内分泌学 在内分泌学.
- 神经眼科神经眼科
背景情况:
- 甲状腺腺素过高通常与垂体腺瘤,药物或全身疾病有关.
- 心理压力是导致益乳素水平升高的一个未被充分认识到的原因.
研究的目的:
- 在患有非典型症状的患者中呈现压力诱导的高乳糖血症病例.
- 强调在诊断内分泌疾病方面采用多学科方法的重要性.
- 强调需要将心理压力视为可能导致高血的潜在原因.
主要方法:
- 一个37岁的女性患有卵巢内膜异位症的病例报告.
- 实验室检查血清益乳素水平升高的情况.
- 多学科评估包括盆腔超声波,脑部MRI和眼科检查与视野测试.
主要成果:
- 检测到血清益乳素水平略微升高.
- 患者出现了新发的,视力模糊和头痛.
- 大脑MRI没有显示下垂体腺瘤;然而,视野测试显示了右侧中央阴影瘤.
- 没有发现过高prolactinemia的次要原因.
结论:
- 在没有其他可识别的原因的情况下,被诊断出压力诱导的超分泌性血症.
- 这一案例强调了诊断内分泌异常与同时出现神经眼科症状的复杂性.
- 一个整体的,多学科的方法是至关重要的,以避免过度诊断,并确保适当的管理的高血.
相关概念视频
Major Hormones and Their Functions
810
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...
810
Regulation of Hormone Secretion
4.1K
Regulation of hormone secretion is a finely tuned orchestration driven by various types of stimuli, encompassing neural, humoral, and hormonal signals. Environmental cues instigate neural stimuli, where action potentials traverse nerve fibers to reach their designated targets. An illustrative scenario is the body's response to stress, wherein the sympathetic nervous system releases epinephrine from the adrenal glands, inducing the well-known 'fight or flight' reaction.
Humoral...
Humoral...
4.1K
The Pituitary Gland
7.3K
The pituitary is a small endocrine organ in the sphenoid bone under the hypothalamus. Primarily, the pituitary in adults has two distinct anatomical and functional regions— the anterior and posterior lobes. During human fetal development, a third pituitary gland region called the pars intermedia atrophies and disappears. However, some of its cells migrate and exist adjacent to the anterior pituitary in adults.
7.3K
Hypothalamic-Pituitary Axis
61.8K
The response to stress—be it physical or psychological, acute or chronic—involves activation of the Hypothalamic-Pituitary-Adrenal (HPA) axis. The HPA axis is part of the neuroendocrine system because it involves both neuronal and hormonal communication. Its function is to regulate homeostatic systems—metabolic, cardiovascular, and immune—providing the necessary means to respond to a stressor.
61.8K
Hormones of the Pituitary Gland
7.1K
The small, pea-sized pituitary gland is located at the base of the brain. It is crucial in regulating various bodily functions, from growth to reproduction. The gland is divided into the anterior lobe and the posterior lobe. The secretory cell clusters in the pars distalis of the anterior pituitary lobe are controlled by hypothalamic regulators and synthesize six primary hormones.
The most abundantly secreted hormone from the anterior lobe is the growth hormone, which controls overall growth by...
The most abundantly secreted hormone from the anterior lobe is the growth hormone, which controls overall growth by...
7.1K
Hypoglycemia and Glucagon
342
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...
342


