Journal Article A Probable Case of Burn-out NASH Caused by Panhypopituitarism Secondary to Craniopharyngioma
頭蓋咽頭腫の長期治療経過に伴う汎下垂体機能低下症により肝硬変症をきたしたと考えられる一例

Terawaki, Yuichi  ,  Murase, Kunitaka  ,  Motonaga, Ryoko  ,  Tanabe, Makito  ,  Nomiyama, Takashi  ,  Shakado, Satoshi  ,  Mizoguchi, Mikiro  ,  Sakisaka, Shotaro  ,  Yanase, Toshihiko

107 ( 3 )  , pp.53 - 61 , 2016-03-25 , Fukuoka Medical Association
ISSN:0016-254X
NCID:AN00215478
Description
A 38-year-old man diagnosed with craniopharyngioma at 8 years old underwent repeated surgery and radiation therapy. Complications included panhypopituitarism including growth hormone deficiency and hypogonadism at 13 years old. At 26 years of age, a slight fatty liver was found, which finally developed into liver cirrhosis (LC) at 35 years old. Viral infection or other etiologies causing LC were negative on serum examinations. Liver biopsy suggested a possibility of burn-out non-alcoholic steatohepatitis. This case indicates that a long-standing growth hormone deficiency and hypogonadism may lead to LC as a type of burn-out non-alcoholic steatohepatitis.
症例は38歳男性.8歳時に頭蓋咽頭腫と診断され,手術及び放射線療法がおこなわれた.その後も再発を繰り返し,13歳時には成長ホルモン分泌不全症及び性腺機能低下症を伴う汎下垂体機能低下症を認めた.26歳時に軽度の脂肪肝を指摘され,35歳時には肝硬変に至った.肝硬変を引き起こすようなウイルス性やその他の肝疾患は血液検査などから否定的であり,肝生検の結果はburn-out NASHが疑われた.本症例の長期経過から,汎下垂体機能低下症に伴う長期のGH分泌不全症に起因するNASHがその原因と推定された.
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http://catalog.lib.kyushu-u.ac.jp/handle/2324/1661293/p053.pdf

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