본 증례는 뇌하수체저하증의 환자에서 간경변증의 동반 가능성을 시사하며, 뇌하수체저하증에서 간경변증의 발병 기전에 대한 연구가 더 이루어져야 하겠다. 뇌하수체저하증의 추적관찰 시에 지방간염 또는 간경변증의 발생 가능성을 항상 고려하여야 하며, 필요한 경우 조직검사를 시행하여 간질환의 진행에 대하여 적극적인 치료를 고려하여야 하겠다. 저자 등은 뇌하수체저하증과 동반된 원인 미상의 간경변증 환자 1예를 경험하였기에 문헌고찰과 함께 보고하고자 한다.
본 증례는 뇌하수체저하증의 환자에서 간경변증의 동반 가능성을 시사하며, 뇌하수체저하증에서 간경변증의 발병 기전에 대한 연구가 더 이루어져야 하겠다. 뇌하수체저하증의 추적관찰 시에 지방간염 또는 간경변증의 발생 가능성을 항상 고려하여야 하며, 필요한 경우 조직검사를 시행하여 간질환의 진행에 대하여 적극적인 치료를 고려하여야 하겠다. 저자 등은 뇌하수체저하증과 동반된 원인 미상의 간경변증 환자 1예를 경험하였기에 문헌고찰과 함께 보고하고자 한다.
Unknown causes of liver cirrhosis continue to be on the decrease after advances in viral, genetic, and immunological testing. Recently, it has been reported that patients with hypopituitarism may have non-alcoholic steatohepatitis and liver,cirrhosis. We report here a case of 48-year-old woman with ...
Unknown causes of liver cirrhosis continue to be on the decrease after advances in viral, genetic, and immunological testing. Recently, it has been reported that patients with hypopituitarism may have non-alcoholic steatohepatitis and liver,cirrhosis. We report here a case of 48-year-old woman with hypopituitarism who developed cryptogenic liver cirrhosis. The patient received insulin therapy for diabetes mellitus for 23 years. About 20 years ago, she also took medication for pulmonary tuberculosis. On physical examination, she showed no secondary sexual expression. On laboratory findings, there was pancytopenia. Markers for hepatitis B and C, autoimmune liver disease, iron overload and α-1-antitrypsin deficiency were all negative. The level of leptin was increased. A pituitary stimulation test showed a decrease of growth hormone, cortisol, ACTH, prolactin, LH, and FSH; the level of TSH was normal. Abdominal ultrasonography showed a cirrhotic liver with ascites and splenomegaly. A brain MRI showed a non-clearly identified pituitary gland of a severely decreased volume. On esophagogastroduodenoscopy, the presence of esophageal varices indicated portal hypertension. All these findings suggest that the patient has a diagnosis of cryptogenic liver cirrhosis with hypopituitarism.
Unknown causes of liver cirrhosis continue to be on the decrease after advances in viral, genetic, and immunological testing. Recently, it has been reported that patients with hypopituitarism may have non-alcoholic steatohepatitis and liver,cirrhosis. We report here a case of 48-year-old woman with hypopituitarism who developed cryptogenic liver cirrhosis. The patient received insulin therapy for diabetes mellitus for 23 years. About 20 years ago, she also took medication for pulmonary tuberculosis. On physical examination, she showed no secondary sexual expression. On laboratory findings, there was pancytopenia. Markers for hepatitis B and C, autoimmune liver disease, iron overload and α-1-antitrypsin deficiency were all negative. The level of leptin was increased. A pituitary stimulation test showed a decrease of growth hormone, cortisol, ACTH, prolactin, LH, and FSH; the level of TSH was normal. Abdominal ultrasonography showed a cirrhotic liver with ascites and splenomegaly. A brain MRI showed a non-clearly identified pituitary gland of a severely decreased volume. On esophagogastroduodenoscopy, the presence of esophageal varices indicated portal hypertension. All these findings suggest that the patient has a diagnosis of cryptogenic liver cirrhosis with hypopituitarism.
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