{"created":"2023-06-20T15:50:31.034458+00:00","id":3302,"links":{},"metadata":{"_buckets":{"deposit":"cca25e96-2cd5-4523-a5e2-adb370556d92"},"_deposit":{"created_by":18,"id":"3302","owners":[18],"pid":{"revision_id":0,"type":"depid","value":"3302"},"status":"published"},"_oai":{"id":"oai:redcross.repo.nii.ac.jp:00003302","sets":["99:64:115"]},"author_link":["7639","6820","7624","49","48","6638","129","7640","47"],"item_5_biblio_info_7":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2008-03-01","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"110","bibliographicPageStart":"105","bibliographicVolumeNumber":"13","bibliographic_titles":[{"bibliographic_title":"徳島赤十字病院医学雑誌"},{"bibliographic_title":"Tokushima Red Cross Hospital Medical Journal","bibliographic_titleLang":"en"}]}]},"item_5_description_5":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"患者は73歳，女性．23歳，第1子出産時に大出血などはなかったが，この時から無月経であった．50歳時に甲状腺機能低下症を指摘され，一時期，治療を受けた．2006年5月に全身倦怠感，悪心，嘔吐に続いて，意識消失をきたして当科に入院した．BMI20.5kg/m2，脈拍40／分，眉毛外側1／3は欠落していた．甲状腺腫はなく，恥毛・体毛は稀少であった．入院時検査で低Na 血症（113mEq/l）があり，血漿ACTH41.7pg/ml，Cortisol7.4μg/dl，尿中cortisol13.9μg／日，17‐OHCS2.6mg／日より続発性副腎不全と診断した．視床下部ホルモン４者負荷試験では，GH，PRL，TSH，FSH，LH は低反応，ACTH は遅延反応を示したことから，下垂体前葉機能低下症と診断した．一方，Free T４＜0.4μg/dl と甲状腺機能低下があり，抗Tg 抗体15.6U/ml，MCHA400倍と慢性甲状腺炎の合併と診断した．下垂体MRIではempty sellaが認められ，抗下垂体抗体は陰性であった．Hydrocortisoneの先行補充後にL-thyroxineの投与を行い，すみやかに症状・低Na 血症とも改善した．本例は周産期に発症したと考えられる下垂体機前葉能低下症で，Sheehan症候群の可能性が高いが，ACTH-cortisol系分泌能の部分的残存のために，発症から50年を経て副腎不全が顕在化した稀な症例と考えられた．","subitem_description_type":"Abstract"}]},"item_5_full_name_3":{"attribute_name":"著者別名","attribute_value_mlt":[{"nameIdentifiers":[{"nameIdentifierScheme":"WEKO"}],"names":[{"name":"YOSHIDA, 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淳一"}],"nameIdentifiers":[{},{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2013-04-11"}],"displaytype":"simple","filename":"trchmj1301_105-110.pdf","filesize":[{"value":"1.1 MB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"pdf002109","url":"https://redcross.repo.nii.ac.jp/record/3302/files/trchmj1301_105-110.pdf"},"version_id":"808c5833-efa6-4898-a620-6a8facf204df"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"下垂体前葉機能低下症","subitem_subject_scheme":"Other"},{"subitem_subject":"副腎不全","subitem_subject_scheme":"Other"},{"subitem_subject":"慢性甲状腺炎","subitem_subject_scheme":"Other"},{"subitem_subject":"Sheehan症候群","subitem_subject_scheme":"Other"},{"subitem_subject":"pituitary anterior lobe dysfunction","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"adrenal failure","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"chronic thyroiditis","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"Sheehan syndrome","subitem_subject_language":"en","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"technical report"}]},"item_title":"慢性甲状腺炎を合併し，推定発症から50年を経て副腎不全症状で発見された下垂体前葉機能低下症の1例","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"慢性甲状腺炎を合併し，推定発症から50年を経て副腎不全症状で発見された下垂体前葉機能低下症の1例"},{"subitem_title":"A Case with Pituitary Anterior Lobe Dysfunction Complicated by Chronic Thyroiditis Detected based on Symptoms of Adrenal Failure ５０Years after the Estimated Time of Onset","subitem_title_language":"en"}]},"item_type_id":"5","owner":"18","path":["115"],"pubdate":{"attribute_name":"公開日","attribute_value":"2013-04-11"},"publish_date":"2013-04-11","publish_status":"0","recid":"3302","relation_version_is_last":true,"title":["慢性甲状腺炎を合併し，推定発症から50年を経て副腎不全症状で発見された下垂体前葉機能低下症の1例"],"weko_creator_id":"18","weko_shared_id":18},"updated":"2023-06-20T22:01:48.020984+00:00"}