Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: Isolated adrenocorticotropic hormone deficiency is a rare disease; however, since immune check point inhibitors (ICIs) have become widely used, many more cases have been reported. In this study, we compared the human leukocyte antigen (HLA) signatures between ICI-induced isolated adrenocorticotropic hormone deficiency (IAD) and idiopathic IAD (IIAD). DESIGN AND METHODS: Clinical features and HLA frequencies were compared among 13 patients with ICI-induced IAD, 8 patients with IIAD, and healthy controls. HLA frequencies of healthy controls were adopted from a HLA database of Japanese population. RESULTS: Age and body mass index were higher, while the rate of weight loss was lower, in patients with ICI-induced IAD than in those with IIAD. No HLA alleles had a significantly higher frequency in patients with ICI-induced IAD than in healthy controls, whereas the frequencies of HLA-DRB1*09:01, HLA-DQA1*03:02, and DQB1*03:03 were significantly higher in patients with IIAD than in healthy controls. CONCLUSIONS: ICI-induced IAD and IIAD were different in terms of HLA frequencies. There were no specific HLAs related to ICI-induced IAD, whereas several HLAs in strong linkage disequilibrium were associated with IIAD. This might suggest that the two diseases have different pathological mechanisms. HLAs unique to IIAD may be helpful in predicting its pathophysiology.

DOI： 10.1007/s11102-022-01231-1

PubMed

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Language：Japanese   Publisher：(一社)日本内分泌学会  

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Language：Japanese   Publisher：(一社)日本内分泌学会  

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Language：Japanese   Publisher：(一社)日本内分泌学会  

先端巨大症に対する経蝶形骨洞手術症例45例を対象に、術後早期の腎機能の変化について検討した。対象は術前eGFR高値群(eGFR 90mL/min/1.73平方m以上)と正常-低値群(eGFR 90mL/min/1.73平方m未満)、65歳未満と65歳以上とに分けて比較した。その結果、術前eGFR高値群は術後早期にeGFRが有意に低下し、術前eGFR正常-低値群は術後に有意な変化は無かった。IGF-Iが術後早期に正常化した群、3ヵ月以上を要した群とも術後早期にeGFRは有意に低下し、GHやIGF-Iの変化量が多いほどeGFRが低下することが判明した。65歳以上群は65歳未満群と比較してeGFRが有意に低く、糖尿病や高血圧症の合併率が有意に高かった。65歳未満群は術後早期にeGFRが有意に低下したが、65歳以上群に有意な変化は無かった。正常-低値群のうち65歳以上で糖尿病と高血圧症の3例は術後にeGFR 60mL/min/1.73平方m未満への低下を認め、高齢者で併存症が多い症例は腎機能低下への注意深い経過観察が必要である。

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2024&ichushi_jid=J01160&link_issn=&doc_id=20240807480007&doc_link_id=%2Fcs6hypop%2F2024%2F0100s1%2F008%2F0025-0026%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcs6hypop%2F2024%2F0100s1%2F008%2F0025-0026%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：Japanese   Publisher：(一社)日本糖尿病学会  

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Language：Japanese   Publisher：(一社)日本内分泌学会  

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