nelson syndrome
Nelson’s syndrome is a condition characterized by chronic adrenal insufficiency, hyperpigmentation of the skin and mucous membranes, and the presence of a pituitary adenoma. Occurs in 5-10% of cases after bilateral total adrenalectomy in Itsenko-Cushing’s disease.
Pathogenesis
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- An increase in ACTH production due to a violation of feedback mechanisms is a key moment in pathogenesis. Effek-Sh
- Stimulation of melanocytes leads to hyperpigmentation of the skin and mucous membranes
- Increased lipolysis and increased insulin secretion cause an increase in fatty acids and hypoglycemia
- An increase in the rate of metabolism of glucocorticoids leads to an increase in their need to compensate for adrenal insufficiency.
- Development of neoplastic processes (paraovarian and paratesticular tumors)
- (3-Lipotropin and α-melanostimulating hormone also stimulate melanocytes.
clinical picture. Hyperpigmentation of the skin and mucous membranes, damage to the III cranial nerves and an increase in the Turkish saddle. Symptoms of adrenal insufficiency (adinamia, arterial hypotension, hypoglycemia, dyspeptic disorders, etc.).
Diagnostics
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- An important criterion is an increase in the level of ACTH in plasma
- Ophthalmological examination (change in the fundus, impaired lateral vision, decreased visual acuity, ptosis).
Treatment
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- Medical
- Glucocorticoids and minera-locorticoids
- Cyprogentadine
- Bromocriptine
- Sodium va-proate (acediprol)
- Surgical treatment (transsphenoidal resection)
- Radiation therapy.