Skip to main content

2018 | OriginalPaper | Buchkapitel

13. Hypophysenvorderlappen und Austestung der glandotropen Achsen

verfasst von : Andreas Schäffler, Cornelius Bollheimer, Roland Büttner, Christiane Girlich, Charalampos Aslanidis, Wolfgang Dietmaier, Margarita Bala, Viktoria Guralnik, Thomas Karrasch, Sylvia Schneider

Erschienen in: Funktionsdiagnostik in Endokrinologie, Diabetologie und Stoffwechsel

Verlag: Springer Berlin Heidelberg

Zusammenfassung

Erläutert werden alle relevanten Funktionstests mit ausführlicher Darstellung von Indikationen, Kontraindikationen, Nebenwirkungen, Testvorbereitung, Rahmenbedingungen, konkreten Handlungsanleitung der eigentlichen Testdurchführung sowie der Interpretation der Testergebnisse. Es werden immer konkrete Normbereiche und Cut-off-Werte angegeben, auch für besondere Situationen (Geschlecht, Alter, BMI, Pubertätsphasen, Zyklusphasen, akute Erkrankungen, Medikamente etc.). Ein besonderes Merkmal ist die Betonung der Testvorbereitung, -durchführung und -interpretation sowie des interdisziplinären Charakters. Die Hypophysenvorderlappen-Hormone und ihre dynamische Funktionstestung werden in diesem Kapitel detailliert behandelt. Auch schwierige, aufwändige und seltene Testverfahren wie Sinus-petrosus-inferior-Katheterisierung, pulsatiler GnRH-Test und kombinierter GHRH-Arginin-Infusions-Test sind ausführlich dargestellt.
Literatur
1.
Zurück zum Zitat Thomas L (2008) Labor und Diagnose, 7. Aufl. TH-Books Verlagsgesellschaft, Frankfurt, S 1444–1445, 1780 Thomas L (2008) Labor und Diagnose, 7. Aufl. TH-Books Verlagsgesellschaft, Frankfurt, S 1444–1445, 1780
2.
Zurück zum Zitat Lehnert H, Allolio B, Buhr HJ, Hahn K, Mann B, Mohnike K, Weiss M (2003) Nebenniere. In: Lehner H (Hrsg) Rationelle Diagnostik und Therapie in Endokrinologie, Diabetologie und Stoffwechsel. Thieme, Stuttgart, S 22–23 Lehnert H, Allolio B, Buhr HJ, Hahn K, Mann B, Mohnike K, Weiss M (2003) Nebenniere. In: Lehner H (Hrsg) Rationelle Diagnostik und Therapie in Endokrinologie, Diabetologie und Stoffwechsel. Thieme, Stuttgart, S 22–23
3.
Zurück zum Zitat Quabbe HJ, Müller OA, Oelkers W, Willig RP (1993) Hypothalamus und Hypophyse. In: Deutsche Gesellschaft für Endokrinologie (Hrsg) Rationelle Diagnostik in der Endokrinologie. Thieme, Stuttgart/New York, S 30 Quabbe HJ, Müller OA, Oelkers W, Willig RP (1993) Hypothalamus und Hypophyse. In: Deutsche Gesellschaft für Endokrinologie (Hrsg) Rationelle Diagnostik in der Endokrinologie. Thieme, Stuttgart/New York, S 30
4.
Zurück zum Zitat Murphy BE (1967) Some studies of the protein-binding of steroids and their application to the routine micro and ultramicro measurement of various steroids in body fluids by competitive protein-binding radioassay. J Clin Endocrinol Metab 27:973–990CrossRefPubMed Murphy BE (1967) Some studies of the protein-binding of steroids and their application to the routine micro and ultramicro measurement of various steroids in body fluids by competitive protein-binding radioassay. J Clin Endocrinol Metab 27:973–990CrossRefPubMed
5.
6.
Zurück zum Zitat Van Rijn JL, Van Landeghem BA, Haima P, Goldschmidt HM (1996) Evaluation of ACTH immunoradiometric assays. Clin Biochem 29:93–95CrossRefPubMed Van Rijn JL, Van Landeghem BA, Haima P, Goldschmidt HM (1996) Evaluation of ACTH immunoradiometric assays. Clin Biochem 29:93–95CrossRefPubMed
7.
Zurück zum Zitat Findling JW, Raff H (2006) Cushing’s syndrome: important issues in diagnosis and management. J Clin Endocrinol Metab 91:3746–3753CrossRefPubMed Findling JW, Raff H (2006) Cushing’s syndrome: important issues in diagnosis and management. J Clin Endocrinol Metab 91:3746–3753CrossRefPubMed
8.
Zurück zum Zitat Oldfield EH, Doppman JL, Nieman LK, Chrousos GP, Miller DL, Katz DA, Cutler GB Jr, Loriaux DL (1991) Petrosal sinus sampling with and without corticotropin-releasing hormone for the differential diagnosis of Cushing’s syndrome. N Engl J Med 325:897–905CrossRefPubMed Oldfield EH, Doppman JL, Nieman LK, Chrousos GP, Miller DL, Katz DA, Cutler GB Jr, Loriaux DL (1991) Petrosal sinus sampling with and without corticotropin-releasing hormone for the differential diagnosis of Cushing’s syndrome. N Engl J Med 325:897–905CrossRefPubMed
9.
Zurück zum Zitat Raff H, Findling JW (2003) A physiologic approach to diagnosis of the Cushing syndrome. Ann Intern Med 138:980–991CrossRefPubMed Raff H, Findling JW (2003) A physiologic approach to diagnosis of the Cushing syndrome. Ann Intern Med 138:980–991CrossRefPubMed
10.
Zurück zum Zitat Fleseriu M, Hashim IA, Karavitaki N, Melmed S, Murad MH, Salvatori R, Samuels MH (2016) Hormonal replacement in hypopituitarism in adults: an endocrine society clinical practive guideline. JCEM 101:3888–3921PubMed Fleseriu M, Hashim IA, Karavitaki N, Melmed S, Murad MH, Salvatori R, Samuels MH (2016) Hormonal replacement in hypopituitarism in adults: an endocrine society clinical practive guideline. JCEM 101:3888–3921PubMed
11.
Zurück zum Zitat Kaltsas GA, Giannulis MG, Newell-Price JD, Dacie JE, Thakkar C, Afshar F, Monson JP, Grossman AB, Besser GM, Trainer PJ (1999) A critical analysis of the value of simultaneous inferior petrosal sinus sampling in Cushing’s disease and the occult ectopic adrenocorticotropin syndrome. J Clin Endocrinol Metab 84:487–492PubMed Kaltsas GA, Giannulis MG, Newell-Price JD, Dacie JE, Thakkar C, Afshar F, Monson JP, Grossman AB, Besser GM, Trainer PJ (1999) A critical analysis of the value of simultaneous inferior petrosal sinus sampling in Cushing’s disease and the occult ectopic adrenocorticotropin syndrome. J Clin Endocrinol Metab 84:487–492PubMed
12.
Zurück zum Zitat Grua JR, Nelson DH (1991) ACTH-producing pituitary tumors. Endocrinol Metab Clin North Am 20:319–362PubMed Grua JR, Nelson DH (1991) ACTH-producing pituitary tumors. Endocrinol Metab Clin North Am 20:319–362PubMed
13.
Zurück zum Zitat Fiad TM, Kirby JM, Cunningham SK, McKenna TJ (1994) The overnight single-dose metyrapone test is a simple and reliable index of the hypothalamic-pituitary-adrenal axis. Clin Endocrinol (Oxf) 40:603–609CrossRef Fiad TM, Kirby JM, Cunningham SK, McKenna TJ (1994) The overnight single-dose metyrapone test is a simple and reliable index of the hypothalamic-pituitary-adrenal axis. Clin Endocrinol (Oxf) 40:603–609CrossRef
14.
Zurück zum Zitat Avgerinos PC, Yanovski JA, Oldfield EH, Nieman LK, Cutler GB Jr (1994) The metyrapone and dexamethasone suppression tests for the differential diagnosis of the adrenocorticotropin-dependent Cushing syndrome: a comparison. Ann Intern Med 121:318–327CrossRefPubMed Avgerinos PC, Yanovski JA, Oldfield EH, Nieman LK, Cutler GB Jr (1994) The metyrapone and dexamethasone suppression tests for the differential diagnosis of the adrenocorticotropin-dependent Cushing syndrome: a comparison. Ann Intern Med 121:318–327CrossRefPubMed
15.
Zurück zum Zitat Tirabassi G et al (2010) Use of the desmopressin test in the differential diagnosis of pseudo-Cushing state from Cushing’s disease. J Clin Endocrinol Metab 95:1115–1122CrossRefPubMed Tirabassi G et al (2010) Use of the desmopressin test in the differential diagnosis of pseudo-Cushing state from Cushing’s disease. J Clin Endocrinol Metab 95:1115–1122CrossRefPubMed
16.
Zurück zum Zitat Vassiliadi DA et al (2016) The Desmopressin Test Predicts Better Than Basal Cortisol the Long-Term Surgical Outcome of Cushing’s Disease. J Clin Endocrinol Metab 101:4878–4885CrossRefPubMed Vassiliadi DA et al (2016) The Desmopressin Test Predicts Better Than Basal Cortisol the Long-Term Surgical Outcome of Cushing’s Disease. J Clin Endocrinol Metab 101:4878–4885CrossRefPubMed
17.
Zurück zum Zitat Colombo P et al (1997) Effect of desmopressin on ACTH and cortisol secretion in states of ACTH excess. Clin Endocrinol (Oxf) 46:661–668CrossRef Colombo P et al (1997) Effect of desmopressin on ACTH and cortisol secretion in states of ACTH excess. Clin Endocrinol (Oxf) 46:661–668CrossRef
18.
Zurück zum Zitat Tirabassi G et al (2011) Corticotrophin-releasing hormone and desmopressin tests in the differential diagnosis between Cushing’s disease and pseudo-Cushing state: a comparative study. Clin Endocrinol (Oxf) 75:666–672CrossRef Tirabassi G et al (2011) Corticotrophin-releasing hormone and desmopressin tests in the differential diagnosis between Cushing’s disease and pseudo-Cushing state: a comparative study. Clin Endocrinol (Oxf) 75:666–672CrossRef
19.
Zurück zum Zitat Wang HF, Huang CC, Chen YF, Ho DM, Lin HD (2007) Pituitary apoplexy after thyrotropin-releasing hormone stimulation test in a patient with pituitary macroadenoma. J Chin Med Assoc 70:392–395CrossRefPubMed Wang HF, Huang CC, Chen YF, Ho DM, Lin HD (2007) Pituitary apoplexy after thyrotropin-releasing hormone stimulation test in a patient with pituitary macroadenoma. J Chin Med Assoc 70:392–395CrossRefPubMed
20.
Zurück zum Zitat Thomas L (2008) Labor und Diagnose, 7. Aufl. TH-Books Verlagsgesellschaft, Frankfurt, S 1387 Thomas L (2008) Labor und Diagnose, 7. Aufl. TH-Books Verlagsgesellschaft, Frankfurt, S 1387
21.
Zurück zum Zitat Partsch CJ, Hummelink R, Sippell WG (1990) Reference ranges of lutropin and follitropin in the luliberin test in prepubertal and pubertal children using a monoclonal immunoradiometric assay. J Clin Chem Clin Biochem 28:49–52PubMed Partsch CJ, Hummelink R, Sippell WG (1990) Reference ranges of lutropin and follitropin in the luliberin test in prepubertal and pubertal children using a monoclonal immunoradiometric assay. J Clin Chem Clin Biochem 28:49–52PubMed
22.
Zurück zum Zitat Wiedemann G, Jonetz-Mentzel L, Panse R (1993) Establishment of reference ranges for follitropin and lutropin in neonates, infants, children and adolescents. Eur J Clin Chem Clin Biochem 31:395–401PubMed Wiedemann G, Jonetz-Mentzel L, Panse R (1993) Establishment of reference ranges for follitropin and lutropin in neonates, infants, children and adolescents. Eur J Clin Chem Clin Biochem 31:395–401PubMed
23.
Zurück zum Zitat Larsen PR, Kronenberg HM, Melme S, Polonsky KS (Hrsg) (2003) Williams textbook of endocrinology. Saunders/Elsevier, Philadelphia Larsen PR, Kronenberg HM, Melme S, Polonsky KS (Hrsg) (2003) Williams textbook of endocrinology. Saunders/Elsevier, Philadelphia
24.
Zurück zum Zitat Leidenberger F (1998) Klinische Endokrinologie für Frauenärzte. Springer, BerlinCrossRef Leidenberger F (1998) Klinische Endokrinologie für Frauenärzte. Springer, BerlinCrossRef
25.
Zurück zum Zitat Smals AG, Hermus AR, Boers GH, Pieters GF, Benraad TJ, Kloppenborg PW (1994) Predictive value of luteinizing hormone releasing hormone (LHRH) bolus testing before and after 36-hour pulsatile LHRH administration in the differential diagnosis of constitutional delay of puberty and male hypogonadotropic hypogonadism. J Clin Endocrinol Metab 78:602–608PubMed Smals AG, Hermus AR, Boers GH, Pieters GF, Benraad TJ, Kloppenborg PW (1994) Predictive value of luteinizing hormone releasing hormone (LHRH) bolus testing before and after 36-hour pulsatile LHRH administration in the differential diagnosis of constitutional delay of puberty and male hypogonadotropic hypogonadism. J Clin Endocrinol Metab 78:602–608PubMed
26.
Zurück zum Zitat Partsch CJ, Sippell WG (1987) Short-term pulsatile administration of luteinizing hormone releasing hormone in male adolescents with multiple idiopathic pituitary hormone deficiencies. Horm Res 25:88–96CrossRefPubMed Partsch CJ, Sippell WG (1987) Short-term pulsatile administration of luteinizing hormone releasing hormone in male adolescents with multiple idiopathic pituitary hormone deficiencies. Horm Res 25:88–96CrossRefPubMed
27.
Zurück zum Zitat Elmlinger MW, Kuhnel W, Weber MM, Ranke MB (2004) Reference ranges for two automated chemiluminescent assays for serum insulin-like growth factor I (IGF-I) and IGF-binding protein 3 (IGFBP-3). Clin Chem Lab Med 42:654–664CrossRefPubMed Elmlinger MW, Kuhnel W, Weber MM, Ranke MB (2004) Reference ranges for two automated chemiluminescent assays for serum insulin-like growth factor I (IGF-I) and IGF-binding protein 3 (IGFBP-3). Clin Chem Lab Med 42:654–664CrossRefPubMed
28.
Zurück zum Zitat Thomas L (2008) Labor und Diagnose, 7. Aufl. TH-Books Verlagsgesellschaft, Frankfurt, S 1463 Thomas L (2008) Labor und Diagnose, 7. Aufl. TH-Books Verlagsgesellschaft, Frankfurt, S 1463
29.
Zurück zum Zitat Clayton PE, Cuneo RC, Juul A, Monson JP, Shalet SM, Tauber M (2005) Consensus statement on the management of the GH-treated adolescent in the transition to adult care. Eur J Endocrinol 152:165–170CrossRefPubMed Clayton PE, Cuneo RC, Juul A, Monson JP, Shalet SM, Tauber M (2005) Consensus statement on the management of the GH-treated adolescent in the transition to adult care. Eur J Endocrinol 152:165–170CrossRefPubMed
30.
Zurück zum Zitat Ranke MB (1993) Endokrinologische Funktionsdiagnostik im Kindes- und Jugendalter. J & J Verlag, Mannheim Ranke MB (1993) Endokrinologische Funktionsdiagnostik im Kindes- und Jugendalter. J & J Verlag, Mannheim
31.
Zurück zum Zitat Thalange NK, Price DA, Gill MS, Whatmore AJ, Addison GM, Clayton PE (1996) Insulin-like growth factor binding protein-3 generation: an index of growth hormone insensitivity. Pediatr Res 39:849–855CrossRefPubMed Thalange NK, Price DA, Gill MS, Whatmore AJ, Addison GM, Clayton PE (1996) Insulin-like growth factor binding protein-3 generation: an index of growth hormone insensitivity. Pediatr Res 39:849–855CrossRefPubMed
32.
Zurück zum Zitat Blum WF, Ranke MB, Savage MO, Hall K (1992) Insulin-like growth factors and their binding proteins in patients with growth hormone receptor deficiency: suggestions for new diagnostic criteria. The Kabi Pharmacia Study Group on Insulin-like Growth Factor I Treatment in Growth Hormone Insensitivity Syndromes. Acta Paediatr Suppl 383:125–126PubMed Blum WF, Ranke MB, Savage MO, Hall K (1992) Insulin-like growth factors and their binding proteins in patients with growth hormone receptor deficiency: suggestions for new diagnostic criteria. The Kabi Pharmacia Study Group on Insulin-like Growth Factor I Treatment in Growth Hormone Insensitivity Syndromes. Acta Paediatr Suppl 383:125–126PubMed
33.
Zurück zum Zitat Engstrom BE, Karlsson FA, Wide L (1998) Marked gender differences in ambulatory morning growth hormone values in young adults. Clin Chem 44:1289–1295PubMed Engstrom BE, Karlsson FA, Wide L (1998) Marked gender differences in ambulatory morning growth hormone values in young adults. Clin Chem 44:1289–1295PubMed
34.
Zurück zum Zitat Soldin SJ, Brugnara C, Wong EC (Hrsg) (2003) Pediatric reference ranges. AACC Press, Washington, DC, S 104–105 Soldin SJ, Brugnara C, Wong EC (Hrsg) (2003) Pediatric reference ranges. AACC Press, Washington, DC, S 104–105
35.
Zurück zum Zitat Ranke MB, Gruhler M, Rosskamp R, Brugmann G, Attanasio A, Blum WF, Bierich JR (1986) Testing with growth hormone-releasing factor (GRF(1-29)NH2) and somatomedin C measurements for the evaluation of growth hormone deficiency. Eur J Pediatr 145:485–492CrossRefPubMed Ranke MB, Gruhler M, Rosskamp R, Brugmann G, Attanasio A, Blum WF, Bierich JR (1986) Testing with growth hormone-releasing factor (GRF(1-29)NH2) and somatomedin C measurements for the evaluation of growth hormone deficiency. Eur J Pediatr 145:485–492CrossRefPubMed
36.
Zurück zum Zitat Audi L, Granada ML, Carrascosa A (1996) Growth hormone secretion assessment in the diagnosis of short stature. J Pediatr Endocrinol Metab 9(Suppl 3):313–324PubMed Audi L, Granada ML, Carrascosa A (1996) Growth hormone secretion assessment in the diagnosis of short stature. J Pediatr Endocrinol Metab 9(Suppl 3):313–324PubMed
37.
Zurück zum Zitat Corneli G, Di Somma C, Baldelli R, Rovere S, Gasco V, Croce CG, Grottoli S, Maccario M, Colao A, Lombardi G, Ghigo E, Camanni F, Aimaretti G (2005) The cut-off limits of the GH response to GH-releasing hormone-arginine test related to body mass index. Eur J Endocrinol 153:257–264CrossRefPubMed Corneli G, Di Somma C, Baldelli R, Rovere S, Gasco V, Croce CG, Grottoli S, Maccario M, Colao A, Lombardi G, Ghigo E, Camanni F, Aimaretti G (2005) The cut-off limits of the GH response to GH-releasing hormone-arginine test related to body mass index. Eur J Endocrinol 153:257–264CrossRefPubMed
38.
Zurück zum Zitat Saini S, Hindmarsh PC, Matthews DR, Pringle PJ, Jones J, Preece MA, Brook CG (1991) Reproducibility of 24-hour serum growth hormone profiles in man. Clin Endocrinol (Oxf) 34:455–462CrossRef Saini S, Hindmarsh PC, Matthews DR, Pringle PJ, Jones J, Preece MA, Brook CG (1991) Reproducibility of 24-hour serum growth hormone profiles in man. Clin Endocrinol (Oxf) 34:455–462CrossRef
39.
Zurück zum Zitat Tassoni P, Cacciari E, Cau M, Colli C, Tosi M, Zucchini S, Cicognani A, Pirazzoli P, Salardi S, Balsamo A et al (1990) Variability of growth hormone response to pharmacological and sleep tests performed twice in short children. J Clin Endocrinol Metab 71:230–234CrossRefPubMed Tassoni P, Cacciari E, Cau M, Colli C, Tosi M, Zucchini S, Cicognani A, Pirazzoli P, Salardi S, Balsamo A et al (1990) Variability of growth hormone response to pharmacological and sleep tests performed twice in short children. J Clin Endocrinol Metab 71:230–234CrossRefPubMed
40.
Zurück zum Zitat Corneli G, Di Somma C, Prodam F, Bellone J, Bellone S, Gasco V, Baldelli R, Rovere S, Schneider HJ, Gargantini L, Gastaldi R, Ghizzoni L, Valle D, Salerno M, Colao A, Bona G, Ghigo E, Maghnie M, Aimaretti G (2007) Cut-off limits of the GH response to GHRH plus arginine test and IGF-I levels for the diagnosis of GH deficiency in late adolescents and young adults. Eur J Endocrinol 157:701–708CrossRefPubMed Corneli G, Di Somma C, Prodam F, Bellone J, Bellone S, Gasco V, Baldelli R, Rovere S, Schneider HJ, Gargantini L, Gastaldi R, Ghizzoni L, Valle D, Salerno M, Colao A, Bona G, Ghigo E, Maghnie M, Aimaretti G (2007) Cut-off limits of the GH response to GHRH plus arginine test and IGF-I levels for the diagnosis of GH deficiency in late adolescents and young adults. Eur J Endocrinol 157:701–708CrossRefPubMed
41.
Zurück zum Zitat Ranke MB, Wallaschofski H (2009) Considerations of growth hormone treatment during the transition from adolescence to adulthood. Dtsch Med Wochenschr 134:1117–1120CrossRefPubMed Ranke MB, Wallaschofski H (2009) Considerations of growth hormone treatment during the transition from adolescence to adulthood. Dtsch Med Wochenschr 134:1117–1120CrossRefPubMed
42.
Zurück zum Zitat Ho KK (2007) Consensus guidelines for the diagnosis and treatment of adults with GH deficiency II: a statement of the GH Research Society in association with the European Society for Pediatric Endocrinology, Lawson Wilkins Society, European Society of Endocrinology, Japan Endocrine Society, and Endocrine Society of Australia. Eur J Endocrinol 157:695–700CrossRefPubMed Ho KK (2007) Consensus guidelines for the diagnosis and treatment of adults with GH deficiency II: a statement of the GH Research Society in association with the European Society for Pediatric Endocrinology, Lawson Wilkins Society, European Society of Endocrinology, Japan Endocrine Society, and Endocrine Society of Australia. Eur J Endocrinol 157:695–700CrossRefPubMed
43.
Zurück zum Zitat Hauffa BP (2014) Wachstumshormontherapie in der Transitionsphase. Endokrinologie-Informationen der DGE, Sonderheft, S 9 Hauffa BP (2014) Wachstumshormontherapie in der Transitionsphase. Endokrinologie-Informationen der DGE, Sonderheft, S 9
44.
Zurück zum Zitat Molitch ME et al (2011) Evaluation and treatment of adult growth hormone deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 96:1587–1609CrossRefPubMed Molitch ME et al (2011) Evaluation and treatment of adult growth hormone deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 96:1587–1609CrossRefPubMed
45.
Zurück zum Zitat Berg C et al (2010) Diagnostic utility of the glucagon stimulation test in comparison to the insulin tolerance test in patients following pituitary surgery. Eur J Endocrinol 162:477–482CrossRefPubMed Berg C et al (2010) Diagnostic utility of the glucagon stimulation test in comparison to the insulin tolerance test in patients following pituitary surgery. Eur J Endocrinol 162:477–482CrossRefPubMed
46.
Zurück zum Zitat Fleseriu M et al (2016) Hormonal replacement in hypopituitarism in adults: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 101:3888–3921CrossRefPubMed Fleseriu M et al (2016) Hormonal replacement in hypopituitarism in adults: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 101:3888–3921CrossRefPubMed
47.
Zurück zum Zitat Hamrahian AH et al (2016) Revised GH and cortisol cut-points for the glucagon stimulation test in the evaluation of GH and hypothalamic-pituitary-adrenal axes in adults: results from a prospective randomized multicenter study. Pituitary 19:332–341CrossRefPubMed Hamrahian AH et al (2016) Revised GH and cortisol cut-points for the glucagon stimulation test in the evaluation of GH and hypothalamic-pituitary-adrenal axes in adults: results from a prospective randomized multicenter study. Pituitary 19:332–341CrossRefPubMed
48.
Zurück zum Zitat Yuen KC et al (2016) American association of clinical endocrinologists and American college of endocrinology disease state clinical review: update on growth hormone stimulation testing and proposed revised cut-point for the glucagon stimulation test in the diagnosis of adult growth hormone deficiency. Endocr Pract Off J Am Coll Endocrinol Am Assoc Clin Endocrinol 22:1235–1244 Yuen KC et al (2016) American association of clinical endocrinologists and American college of endocrinology disease state clinical review: update on growth hormone stimulation testing and proposed revised cut-point for the glucagon stimulation test in the diagnosis of adult growth hormone deficiency. Endocr Pract Off J Am Coll Endocrinol Am Assoc Clin Endocrinol 22:1235–1244
49.
Zurück zum Zitat Kavanagh L, McKenna TJ, Fahie-Wilson MN, Gibney J, Smith TP (2006) Specificity and clinical utility of methods for the detection of macroprolactin. Clin Chem 52:1366–1372CrossRefPubMed Kavanagh L, McKenna TJ, Fahie-Wilson MN, Gibney J, Smith TP (2006) Specificity and clinical utility of methods for the detection of macroprolactin. Clin Chem 52:1366–1372CrossRefPubMed
50.
Zurück zum Zitat Sanchez-Eixeres MR, Mauri M, Alfayate R, Graells ML, Miralles C, Lopez A, Pico A (2001) Prevalence of macroprolactin detected by Elecsys 2010. Horm Res 56:87–92PubMed Sanchez-Eixeres MR, Mauri M, Alfayate R, Graells ML, Miralles C, Lopez A, Pico A (2001) Prevalence of macroprolactin detected by Elecsys 2010. Horm Res 56:87–92PubMed
Metadaten
Titel
Hypophysenvorderlappen und Austestung der glandotropen Achsen
verfasst von
Andreas Schäffler
Cornelius Bollheimer
Roland Büttner
Christiane Girlich
Charalampos Aslanidis
Wolfgang Dietmaier
Margarita Bala
Viktoria Guralnik
Thomas Karrasch
Sylvia Schneider
Copyright-Jahr
2018
Verlag
Springer Berlin Heidelberg
DOI
https://doi.org/10.1007/978-3-662-55914-7_13

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Bei seelischem Stress sind Checkpoint-Hemmer weniger wirksam

03.06.2024 NSCLC Nachrichten

Wie stark Menschen mit fortgeschrittenem NSCLC von einer Therapie mit Immun-Checkpoint-Hemmern profitieren, hängt offenbar auch davon ab, wie sehr die Diagnose ihre psychische Verfassung erschüttert

Antikörper mobilisiert Neutrophile gegen Krebs

03.06.2024 Onkologische Immuntherapie Nachrichten

Ein bispezifischer Antikörper formiert gezielt eine Armee neutrophiler Granulozyten gegen Krebszellen. An den Antikörper gekoppeltes TNF-alpha soll die Zellen zudem tief in solide Tumoren hineinführen.

Erhebliches Risiko für Kehlkopfkrebs bei mäßiger Dysplasie

29.05.2024 Larynxkarzinom Nachrichten

Fast ein Viertel der Personen mit mäßig dysplastischen Stimmlippenläsionen entwickelt einen Kehlkopftumor. Solche Personen benötigen daher eine besonders enge ärztliche Überwachung.

Nach Herzinfarkt mit Typ-1-Diabetes schlechtere Karten als mit Typ 2?

29.05.2024 Herzinfarkt Nachrichten

Bei Menschen mit Typ-2-Diabetes sind die Chancen, einen Myokardinfarkt zu überleben, in den letzten 15 Jahren deutlich gestiegen – nicht jedoch bei Betroffenen mit Typ 1.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.