Acromegaly presenting with myelopathy due to ossification of posterior longitudinal ligament: a case report.
Acromegaly presenting with myelopathy due to ossification of posterior longitudinal ligament: a case report.
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DOI：
10.1186/s12891-021-04232-6
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发表时间：
2021-04-14
影响因子：
2.3
通讯作者：
Takahashi H
中科院分区：
文献类型：
--
作者：
Kamakura D;Fukutake K;Nakamura K;Tsuge S;Hasegawa K;Tochigi N;Wada A;Mikami T;Takahashi H
肢端肥大症是一种罕见的疾病，由高血清水平的生长激素（GH）和胰岛素样生长因子1（IGF-1）引起，通常起源于垂体腺瘤。脊柱和外周关节异常是由这些激素分泌过多引起的。特别是，对GH的反应涉及体外脊柱韧带骨化的发生，特别是后纵韧带骨化（OPLL）。然而，由于肢端肥大症和OPLL是罕见的疾病，我们很少遇到他们的组合。据我们所知，在英文文献中，这是第一个报告的情况下，肢端肥大症提出胸椎脊髓病由于OPLL。一位47岁的女性出现下肢无力和感觉异常、步态障碍和膀胱疾病，无任何创伤。病人最显著的症状是截瘫，我们诊断为脊髓病，由于颈部和胸部OPLL。此外，我们怀疑肢端肥大症，因为特征性的面部特征，我们发现了一个垂体腺瘤的对比增强磁共振成像。行颈胸减压、后路固定和垂体腺瘤切除术。我们报告一个肢端肥大症的情况下，发现后诊断OPLL。肢端肥大症的主要挑战是诊断延迟。即使在这种情况下，肢端肥大症的面部特征也至少在9年前出现。肢端肥大症的早期诊断和治疗可改善预后，并通过早期干预减少GH和IGF-1的暴露，似乎可以抑制韧带骨化的进展。骨科医生和神经外科医生需要记住，肢端肥大症与骨/关节病变和脊柱韧带骨化有关，应旨在早期诊断肢端肥大症。
Acromegaly is a rare disease caused by high serum levels of growth hormone (GH) and insulin-like growth factor 1 (IGF-1), often originating from a pituitary adenoma. Spinal and peripheral joint abnormalities are caused by these hormonal hypersecretions. In particular, the response to GH is involved in the onset of ossification of the spinal ligament in vitro, especially ossification of the posterior longitudinal ligament (OPLL). However, because acromegaly and OPLL are rare diseases, we seldom encounter them in combination. To the best of our knowledge in the English-language literature, this is the first reported case of acromegaly presenting with thoracic myelopathy due to OPLL. A 47-year-old woman presented with lower extremity weakness and paresthesia, gait disorder, and bladder disorder without any trauma. The patient’s most remarkable symptom was paraplegia, and we diagnosed myelopathy due to cervical and thoracic OPLL. Furthermore, we suspected acromegaly because of the characteristic facial features, and we found a pituitary adenoma by contrast-enhanced MRI. Cervical and thoracic decompression, posterior fixation, and pituitary adenoma resection were performed. We report a case of acromegaly that was detected after the diagnosis of OPLL. The main challenge in acromegaly is delayed in diagnosis. Even in this case, the facial features characteristic of acromegaly had appeared at least 9 years ago. Early diagnosis and treatment of acromegaly improve prognosis and reduce exposure to GH and IGF-1 through early intervention and seem to suppress the progression of ligament ossification. Orthopedic surgeons and neurosurgeons need to keep in mind that acromegaly is associated with bone/joint lesions and ossification of the spinal ligament and should aim to diagnose acromegaly early.
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影响因子：
5.8
作者：
Holdaway, IM;Rajasoorya, RC;Gamble, GD
通讯作者：
Gamble, GD
影响因子：
--
作者：
Holdaway, I. M.
通讯作者：
Holdaway, I. M.
影响因子：
5.8
作者：
Scarpa, R;De Brasi, D;Colao, A
通讯作者：
Colao, A
DOI：
10.1111/j.1440-1673.1969.tb01614.x
发表时间：
1969-01-01
期刊：
AUSTRALASIAN RADIOLOGY
影响因子：
--
作者：
BREIDAHL, P
通讯作者：
BREIDAHL, P
影响因子：
5.8
作者：
Nachtigall, Lisa;Delgado, Adriano;Klibanski, Anne
通讯作者：
Klibanski, Anne