ヨネダ チヒロ   Yoneda Chihiro
  米田 千裕
   所属   その他 その他
   職種   登録医
論文種別 原著
言語種別 英語
査読の有無 査読あり
表題 An autopsy case of macroglobulinemia complicated with syndrome of inappropriate secretion of ADH (SIADH) like hyponatremia, hypopituitarism and AL amyloidosis.
掲載誌名 正式名:Endocrine journal
略  称:Endocr J
ISSNコード:(1348-4540)0918-8959(Linking)
掲載区分国外
巻・号・頁 61(5),pp.417-23
著者・共著者 ◎Yamada Chika, ◎Yoneda Chihiro, Ogino Jun, Fukushima Sayaka, Kodama Shoko, Asano Chihiro, Masuda Michihiko, Horie-Tajima Kanako, Toyonaga Aiko, Hiroshima Kenzo, Kawamura Shunji, Hashimoto Naotake
発行年月 2014
概要 An 88-year-old male patient with macroglobulinemia was admitted to our hospital because of severe hyponatremia and unconsciousness. Laboratory findings showed decreased inhibition of antidiuretic hormone (ADH) and he was diagnosed with syndrome of inappropriate secretion of ADH (SIADH). Hyponatremia improved with only limitation of water intake and the patient was followed up on a continuing outpatient basis. However, soon after discharge from hospital, his legs started swelling with edema and hyponatremia worsened. He was re-admitted due to a fall at home. Hyponatremia was observed at re-admission. A CRH challenge test showed partial dysfunction of ACTH secretion. Corticosteroid therapy was performed, but the patient subsequently died from pneumonia. Pathological findings at autopsy revealed invasion of plasma cells and amyloid depositions in multiple organs, including the pituitary, adrenal cortex, heart, liver, kidney, lymph nodes and bone marrow. Consistent with these results, fibrosis was observed in the anterior lobe of the pituitary, suggesting that the autopsy findings were related to the clinical observations and diagnosis. This is the first reported case of macroglobulinemia complicated with multiple hormone dysfunction.
DOI 10.1507/endocrj.EJ15-0647
PMID 24521938