ometendoОжирение и метаболизмObesity and metabolism2071-87132306-5524Endocrinology Research Centre10.14341/omet12768ometendo-12768Research ArticleСлучай из практикиCase ReportОпыт применения аналогов соматостатина пролонгированного действия у пациентов с ТТГ-секретирующими аденомами гипофизаLong action somatostatin analogues in patients with TSH-secreted pituitary adenomas: treatment experiencehttps://orcid.org/0000-0002-0327-4619ДзерановаЛ. К.DzeranovaL. K.

Дзеранова Лариса Константиновна - доктор медицинских наук; eLibrary SPIN: 2958-5555.

Москва

Larisa K. Dzeranova - MD, PhD; eLibrary SPIN: 2958-5555

Moscow

dzeranovalk@yandex.ruhttps://orcid.org/0000-0003-0047-7223ШутоваА. С.ShutovaA. S.

Шутова Александра Сергеевна – аспирант; eLibrary SPIN 4774-0114.

117036, Москва, ул. Дм. Ульянова, д. 11

Aleksandra S. Shutova - MD, postgraduate student; eLibrary SPIN 4774-0114.

11 Dm. Ulyanova street, 117036 Moscow

shutova.aleksandra@gmail.comhttps://orcid.org/0000-0001-6539-466XПигароваЕ. А.PigarovaE. A.

Пигарова Екатерина Александровна - доктор медицинских наук; eLibrary SPIN: 6912-6331.

Москва

Ekaterina A. Pigarova - MD, PhD; eLibrary SPIN: 6912-6331

Moscow

kpigarova@gmail.comhttps://orcid.org/0000-0002-6963-8294СтаростинаП. А.StarostinaP. A.

Старостина Полина Андреевна; eLibrary SPIN: 5295-0536.

Москва

Polina A. Starostina; eLibrary SPIN: 5295-0536

Moscow

pollina.a.p@yandex.ruhttps://orcid.org/0000-0002-5497-835XХуцишвилиН. А.KhutsishviliN. A.

Хуцишвили Наталья Андреевна; eLibrary SPIN: 4320-0752.

Москва

Natalia A. Khutsishvili; eLibrary SPIN: 4320-0752

Moscow

khutsishvilinatalia98@gmail.comhttps://orcid.org/0000-0001-7470-1676ВоротниковаС. Ю.VorotnikovaS. Yu.

Воротникова Светлана Юрьевна; eLibrary SPIN: 6571-1206.

Москва

Svetlana Yu. Vorotnikova - MD; eLibrary SPIN: 6571-1206

Moscow

vorotnikova.s.y@gmail.comhttps://orcid.org/0000-0002-9575-4520ГригорьевА. Ю.GrigorievA. Yu.

Григорьев Андрей Юрьевич - доктор медицинских наук; eLibrary SPIN 8910-8130.

Москва

Andrei Yu. Grigoriev - MD, PhD; eLibrary SPIN 8910-8130

Moscow

medway26@gmail.comhttps://orcid.org/0000-0002-6109-7550ИващенкоО. В.IvashchenkoO. V.

Иващенко Оксана Владимировна; eLibrary SPIN 7031-3273.

Москва

Oksana V. Ivashchenko - MD; eLibrary SPIN 7031-3273

Moscow

leviv@rambler.ruhttps://orcid.org/0000-0001-9718-6099АзизянВ. Н.AzyanV. N.

Азизян Вилен Неронович - кандидат медицинских наук; eLibrary SPIN: 7666-5950.

Москва

Vilen N. Azyan - MD, PhD; eLibrary SPIN: 7666-5950

Moscow

vazizyan@mail.ruhttps://orcid.org/0000-0003-4353-6705ЛапшинаА. М.LapshinaA. M.

Лапшина Анастасия Михайловна - кандидат медицинских наук; eLibrary SPIN 1582-5033.

Москва

Anastasia M. Lapshina - MD, PhD; eLibrary SPIN 1582-5033

Moscow

nottoforget@yandex.ruНациональный медицинский исследовательский центр эндокринологииРоссияEndocrinology Research CentreRussian Federation202119022022184438446Copyright © Дзеранова Л.К., Шутова А.С., Пигарова Е.А., Старостина П.А., Хуцишвили Н.А., Воротникова С.Ю., Григорьев А.Ю., Иващенко О.В., Азизян В.Н., Лапшина А.М., 20222022Дзеранова Л.К., Шутова А.С., Пигарова Е.А., Старостина П.А., Хуцишвили Н.А., Воротникова С.Ю., Григорьев А.Ю., Иващенко О.В., Азизян В.Н., Лапшина А.М.Dzeranova L.K., Shutova A.S., Pigarova E.A., Starostina P.A., Khutsishvili N.A., Vorotnikova S.Y., Grigoriev A.Y., Ivashchenko O.V., Azyan V.N., Lapshina A.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.omet-endojournals.ru/jour/article/view/12768

Тиреотоксикоз, проявляющийся жалобами на повышенную возбудимость и эмоциональную лабильность, эпизоды сердцебиения, повышение уровней свободных тетрайодтиронина (Т4) и трийодтиронина (Т3) в сыворотке крови, является одним из наиболее распространенных эндокринологических синдромов. Однако при интерпретации показателей тиреоидного статуса необходимо учитывать вероятность наличия у пациента центрального генеза данного состояния. Важную роль играет своевременная диагностика тиреотропином, так как она ассоциирована с улучшением отдаленного прогноза и увеличением продолжительности жизни пациентов. Необходимо отметить, что у некоторых пациентов с аденомами гипофиза, секретирующими тиреотропный гормон (ТТГ), в клинической картине заболевания на первый план выступают проявления гиперпродукции прочих тропных гормонов аденогипофиза, в первую очередь — соматотропного гормона и пролактина, что приводит к развитию акромегалии или гиперпролактинемии соответственно. В статье на примере 2 пациентов представлены принципы диагностики и патогномоничные клинические проявления тиреотропином, а также продемонстрирована эффективность применения аналогов соматостатина в лечении этой патологии. Использование препаратов данной группы как в пред-, так и в послеоперационном периоде позволяет нивелировать гормональную активность ТТГ-секретирующей аденомы, предотвратить развитие необратимых метаболических осложнений и улучшить качество жизни пациентов.

Thyrotoxicosis, which characteristics are increased excitability, emotional lability, tachycardia episodes, increasing of free fractions of tetraiodothyronine (T4) and triiodothyronine (T3) is one of the most common endocrinological syndromes. However, during the interpretation of thyroid status it is very important to take into account the possibility that a patient has TSH-secreting pituitary adenoma. Timely diagnosis of TSH-secreting adenomas plays prominent role in guiding the treatment course since it is associated with an improvement of long-term prognosis and an increase of the patient’s total life expectancy. Needed to underline that in some patients with TSH-secreting adenomas manifestations of the other pituitary hormones hypersecretion (first of all — somatotropin and prolactin) come to the fore, that lead to the development of acromegaly and hyperprolactinemia accordingly. Our work basing on two clinical cases presents main principles of diagnosis and specific clinical manifestations of TSH-secreting pituitary adenomas and demonstrates efficacy of somatostatin analogues in the treatment of this pathology.

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The authors declare that there are no conflicts of interest present.