Hiromichi Kijima

Interleukin-6 (IL-6) producing phaeochromocytoma: direct IL-6 suppression by non-steroidal anti-inflammatory drugs.

A 35‐year‐old Japanese woman presented with a phaeochromocytoma and demonstrated marked inflammatory reactions and pyrexia as a result of excessive production of interleukin‐6 (IL‐6) by the tumour. Serum IL‐6 level was 262 ng/l (normal; < 4·0 ng/l). Fever and inflammatory markers were largely overcome by the administration of the nonsteroidal anti‐inflammatory drug, naproxen, and all symptoms disappeared soon after the tumour was excised. Immunohistochemical study revealed positive staining using an antihuman IL‐6 antibody and Northern analysis showed increased IL‐6 mRNA levels in the tumour. Cultured tumour cells showed IL‐6 protein synthesis, and nonsteroidal anti‐inflammatory drugs such as naproxen and indomethacin directly inhibited IL‐6 release. These results indicate that the effects of naproxen in vivo were due, at least in part, to direct suppression of IL‐6 secretion from the tumour.

A rare case of acromegaly associated with pachydermoperiostosis

Pachydermoperiostosis (PDP) is a rare syndrome manifested clinically by finger clubbing, extremity enlargement, hypertrophic skin changes, and periosteal bone formation. The pathogenesis of the disorder has not been clarified and few endocrine abnormalities were apparent. We report here a 58-year-old man with acromegaly associated with PDP, the features of clubbed fingers, coarse skin, and cutis verticis gyrata. Acromegaly due to GH-producing pituitary adenoma was confirmed in endocrinological and pathological studies.