Adrenal Function in Central Nervous System Disease

摘要

Evaluation of endocrine function has been performed in 35 patients with disease involving the hypothalamus or pitiutary. Almost all of these patients presented with no clinical evidence of endocrinopathy. The most frequently found abnormality was an alteration of the pattern of the diurnal variation of the plasma 17-hydroxycorticosteroids (OHCS). This abnormality occurred in 16 of 18 patients with hypothalamic disease and 6 of 12 patients with sellar disease. In 5 cases with abnormal curves who showed clinical improvement following radiotherapy, the pattern of diurnal variation of the plasma 17-OHCS became normal, whereas in 2 patients with abnormal curves who experienced no clinical improvement following radiotherapy the curves remained abnormal. Blood serotonin levels were decreased or immeasurable in 8 of 11 patients with hypothalamic disease and 4 of 8 patients with sellar disease. Patients with central nervous system disease outside the hypothalamic-limbic system area appear to have normal blood serotonin levels. The Metopirone test did not appear to be of great value in disclosing possible endocrine deficits in this group of patients. It was abnormal in only 2 of 17 patients with hypothalamic disease and 2 of 13 patients with sellar disease. (Author)