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Biomedical subjects

R Pelkonen

Publications and source records attributed to R Pelkonen.

At least 145 records · Page 8Linked to original sources
PubMed1976

Thyroid function in acromegaly before and after transsphenoidal hypophysectomy followed by cryoapplication.

Thyroid function was studied in acromegaly before and after transsphenoidal hypophysectomy followed by cryoapplication. The clinical material comprised 36 euthyroid, 1 hypothyroid and 3 hyperthyroid patients. In addition to the usual thyroid parameters a standard thyrotrophin-releasing hormone (TRH) stimulation test using 200 mug of synthetic TRH given iv was used. In untreated acromegaly with euthyroidism the response of serum TSH to TRH was significantly less than in normal controls, the increment being 7.1 mU/1 vs. 12.5 mU/1. In 23% of the patients the response was subnormal (less than 3.0 mU/1). The total thyroxine was significantly higher than in controls. Goitre occurred in 53% of the patients. After operation 3 patients became hypothyroid. In 30% of the patients remaining euthyroid the response to TRH was subnormal and the mean response in this group was close to the lower normal limit of 3.0 mU/1. In 7 patients who showed a subnormal response to TRH before or shortly after the operation there was a gradual increase and normalization of the response during the next few years. A subnormal, and also a low normal response to TRH before or after hypophysectomy does not necessarily indicate an increased risk for the development of hypothyroidism, and indeed the pituitary remnant seems to have a remarkable capacity for regeneration. In the hypothyroid patient there was a low normal response to TRH, the reason being unknown. In one of the hyperthyroid patients the basal TSH level was 6.5 and 8.9 mU/1 on two occasions in the thyrotoxic phase, showing a small response to TRH. The possibility that hyperthyroidism was due to increased secretion of TSH is discussed but not claimed proven. The incidence of hyperthyroidism in a large material of acromegaly from this department equals 9% which is above the prevalence of hyperthyroidism in the general population in Finland, indicating that acromegaly in one way or another seems to increase the incidence of manifest thyrotoxicosis.

Acromegaly↗
PubMed1976

Conventional pituitary irradiation in acromegaly. Effect on growth hormone and TSH secretion.

Thirty-one patients who had been treated for acromegaly for 1-21 years with conventional pituitary irradiation were re-examined. Immunoreactive growth hormone (GH) was measured in connection with an oral glucose load. Adrenal and gonadal functions were assessed on the basis of plasma cortisol and the urinary excretion of 17-ketogenic steroids, 17-ketosteroids and gonadotrophins. In evaluating the thyroid-pituitary axis the thyrotrophin-releasing hormone stimulation test (TRH) was used. Initially 30 patients had experienced definite benefit from the treatment but at the time of re-examination 10 still had clinically active disease and required another type of treatment. Normal GH levels (less than 5 ng/ml/1) were seen in only 12 patients. Skin thickness was normal in 15 out of 30. Thus the remission rate can be evaluated as being 67% as regards clinical activity, 50% with regard to skin thickness and 39% in terms of GH levels. Hypogonadism occurred in 12 patients (39%) and adrenal and thyroid failure in 5 patients each (16%). The response to TRH was within the normal range in 2 of the hypothyroid patients. In 22 euthyroid patients the mean increment in serum TSH in response to 200 mug of synthetic TRH was only 5.8 mU/1 which was significantly below the normal mean 12.5 mU/1. Furthermore, in 7 of these patients (32%) the response was absent or subnormal (less than 3.0 mU/1). This indicated that the pituitary is capable of secreting enough TSH for maintenance of an euthyroid state but that its capacity is limited. Conventional pituitary irradiation is not a very effective treatment in acromegaly but may still be recommended in selected cases.

Acromegaly↗
PubMed1976

Association of precipitating anti-adrenal anti-adrenal antibodies with moniliasis-polyendocrinopathy syndrome.

The association of precipitating anti-adrenal antibodies with different subgroups of idiopathic Addison's disease were studied. We had previously found these antibodies in patients with the moniliasis-polyendocrinopathy syndrome. Sera of 36 adult patients suffering from different froms of Addison's disease were examined for the presence of adrenal antibodies demonstrable either by immunofluorescence (IFL) or by gel diffusion. 3 of the 17 patients with tuberculous and 17 of 19 patients with idiopathic Addison's disease had IFL antibodies but only one had precipitating antibodies. There was one typical case of Schmidt's syndrome, and four additional cases with Addison's disease combined with diabetes or thyroiditis, who may later develop the syndrome. None of htese patients had precipitating anti-adrenal antibodies. The only patients with precipitating adrenal antibodies had the moniliasis-polyendocrinopathy syndrome. He was not typical as Addison' disease appeared unusually late and he did not have hypoparathyroidism. The presence of precipitating anti-adrenal antibodies in this patient, and the absence of these in other groups of Addison's disease, is further evidence for the association of precipitating antibodies with the moniliasis-polyendocrinopathy syndrome.

Addison Disease↗
PubMed1975

Serum lipids in acromegaly.

Serum cholesterol and triglyceride concentrations were determined in 46 patients with active acromegaly but with otherwise intact pituitary function. The mean serum-cholesterol level of the patients was lower and the mean serum-triglyceride higher than in the basic population of comparable age. The incidence of hypercholesterolemia was similar to that in general population, whereas the incidence of type IV hypertriglyceridemia was almost three times higher than in control population. The serum triglyceride level was not related to relative body weight, basal serum growth hormone, or insulin concentrations, nor did it correlate with glucose tolerance or with plasma-insulin response to oral glucose. However, the patients with highest plasma-insulin response had significantly higher serum triglyceride than the rest of the acromegalic group. The endogenous serum-triglyceride turnover rate showed no consistent changes, but increased serum triglyceride was associated with increased production rate. Upon successful surgical treatment of the acromegaly, serum-triglyceride level decreased in most of the cases who initially had hypertriglyceridemia. It is concluded that acromeagaly can give rise to moderate secondary hypertriglyceridemia.

Acromegaly↗