Cigdem Tura Bahadir

An unusual coexistence of Addison’s disease and phaeochromocytoma

The adrenal gland consists of two endocrine tissues of different embryological origin, namely the primarily steroid-producing adrenocortical tissue, and the catecholamine-producing chromaffin cells. 1 Adrenal catecholamines and steroids are important regulators of the stress response, immune function, blood pressure and energy homeostasis. 2 Chromaffin cells regulate steroid hormone release by the adrenal cortex. Steroids induce catecholamine production in the medulla. Consequently, disorders of the adrenal cortex have been shown to affect chromaffin cell function and vice versa. 3 We report on a patient with an unusual combination of Addison’s disease and phaeochromocytoma, whose initial presentation was adrenocortical failure. After replacement therapy for adrenocortical failure, a clinical presentation of phaeochromocytoma emerged.

Pegvisomant tedavisi sonuçlarımız ve literatürün gözden geçirilmesi

Akromegali, artmis buyume hormonu (BH) sekresyonu ve artmis insulin benzeri buyume hormonu-1 (IGF-1) seviyeleri ile karakterize kronik bir hastaliktir. Akromegalide tedavi secenekleri cerrahi, radyoterapi ve medikal tedavidir. Medikal tedavide somatostatin analoglari, dopamin agonistleri ve pegvisomant kullanilmaktadir. Pegvisomant, buyume hormonu reseptor antagonisti olup etkisini reseptor dimerizasyonunun engellenmesi ile birlikte IGF-1 salinimi icin gerekli intraseluler yolaklari engelleyerek gosterir. Cerrahi ve maksimum doz ve kombinasyonda medikal tedaviye ragmen biyokimyasal yanit saglanamayan hastalarda ucuncu basamak tedavide kullanilir. Bu derlemede, akromegali tedavisinde diger seceneklere gore nispeten yeni olan pegvisomant tedavisi klinigimizdeki tedavi sonuclarimiz ile birlikte guncel literatur isiginda tekrar gozden gecirilmistir.