Publications by authors named "G Iguchi"
Metyrapone is commonly used in the initial management of Cushing's syndrome to reduce hypercortisolemia, but its optimal dosage and timing can vary significantly between patients. Currently, there are limited guidelines on adjustment methods for its administration to individual needs. This study aimed to evaluate responsiveness of each patient to metyrapone and identify the patient characteristics associated with the indices of cortisol responsiveness following a low-dose metyrapone.
View Article and Find Full Text PDFPurpose: To elucidate the long-term efficacy and safety of growth hormone replacement therapy (GHRT) in Japanese patients with adult growth hormone deficiency (AGHD).
Methods: We conducted a retrospective study. A total of 110 patients with AGHD receiving GHRT were enrolled.
Article Synopsis
- A 52-year-old woman with breast cancer experienced fatigue and was found to have isolated adrenocorticotropic hormone (ACTH) deficiency (IAD), but her pituitary gland appeared normal.
- Although there was initial suspicion of paraneoplastic IAD related to her cancer, tests showed no signs of ectopic ACTH in her tumor tissue, leading to a diagnosis of idiopathic acquired IAD instead.
- The case highlights the complexity of diagnosing IAD in cancer patients, as symptoms overlap with those of malignancies, and not all patients with IAD and cancer will develop paraneoplastic syndrome.
Article Synopsis
- The study investigates the discrepancies between patient-reported and physician-assessed symptoms of Cushing's syndrome (CS), highlighting challenges in early diagnosis and treatment.
- It includes a retrospective analysis of 52 patients with CS to compare their reported manifestations with those identified by physicians, focusing on typical and nonspecific symptoms.
- Findings reveal that while patients correlated well with physicians on nonspecific symptoms, they reported fewer typical symptoms, which are critical for diagnosis, indicating that patients may not recognize these typical features as problems.
Article Synopsis
- - A patient with systemic lupus erythematosus (SLE) exhibited deficiencies in thyroid-stimulating hormone (TSH), luteinizing hormone (LH), and follicle-stimulating hormone (FSH), along with MRI evidence of slight pituitary gland atrophy.
- - Immunofluorescence analysis indicated that the patient's immune system produced antibodies that targeted CGA-positive cells in the pituitary, suggesting a link between SLE and autoimmunity against these hormone-producing cells.
- - This case introduces the concept of acquired hypopituitarism, raising questions about the prevalence of TSH, LH, and FSH deficiencies in SLE and similar autoimmune disorders that warrant further investigation.