24
Anhang A Pharmaka zur Diagnostik und Therapie neuroendokriner Erkrankungen – 206 B Datenbanken und sonstige Informationsquellen – 211 8
Anhang
A Pharmaka zur Diagnostik und Therapie neuroendokriner
Erkrankungen – 206
B Datenbanken und sonstige Informationsquellen – 211
8
.Ta
belle
A1.
PraparatezurDiagnostik
hyp
othalam
isch-hyp
ophysarer
Erkran
kungen
Praparat
Han
delsnam
eMen
ge
Applikationsart
Test
Hersteller
Releasingh
ormon
e
CRH
CRH-Ferring
j10
0lg/Amp.
i.v.
HVL-Fu
nktion,Differen
zialdiagnose
des
Cushing-Syn
droms
Ferring
GHRH
GHRH-Ferring
j50
lg/Amp.
i.v.
HVL-Fu
nktion,
Diagnose
des
GH-M
angels
Ferring
GnRH
LH-RH-Ferring
j
Relefact-LH
RH
100lg/Amp.
i.v.
HVL-Fu
nktion,speziellGonad
enfunktion
Ferring
Aventis
TRH
RelefactTR
Hj
TRH-Ferring
200lg/Amp.
i.v.
HVL-Fu
nktion,nichtbei
Makroad
enomen
Aventis
Ferring
Hypop
hysenhormon
e
ACTH
Synacthen
j25
0lg/Amp.
i.v.
NNR-Funktion
Novartis
hCG
Choragon
j
Predalon
j
500I.E.,
1500
I.E.
oder
5000
I.E./Amp.
i.m.
EndokrineHoden
funktion
Ferring
Organ
on
DDAVP
Minirin
j4lg/Amp.
i.v.
Differen
zialdiagnose
Cushing-Syn
drom,
Differen
zialdiagnose
Diabetes
insipidus
Ferring
Pharmakaun
dStoffwechselsub
strate
Metyrap
on
Metopiron
j75
0mg/Tbl.
p.o.
HVL-NNR-Funktion
Novartis,au
sdem
Auslan
dzu
beziehen
Dexam
ethason
Fortecortin
j2mg/Tbl
p.o.
Diagnostik
des
Cushing-Syn
droms
Merck
Clomife
nClom
Hexal
j,
Clomife
n-ratiopharm
50mg/Tbl.
p.o.
Gonad
enfunktion
Hexal,Ratiopharm
Metoclopramid
Paspertin
j10
mg/Amp.
i.v.
Stim
ulationder
PRL-Sekretion
Solvay
Clonidin
Catap
resan
j15
0lg/Tbl.
p.o.
Stim
ulationder
GH-Sekretion
Boeh
ringer
Arginin
Arginin
Hyd
rochlorid
j21
,1g/100
ml
i.v.
Stim
ulationder
GH-Sekretion
Ferringoder
Braun
Gluko
seDextroO.G-T
j.
75g
p.o.
Suppressionder
GH-Sekretion
Roche
206 Kapitel 8 � Anhang
8
.Ta
belle
A2.
PraparatezurSu
bstitutionstherap
iehyp
othalam
isch-hyp
ophysarer
Ausfalle
Praparat
Han
delsnam
eDarreichungsform
Indikation
Hersteller
Wachstumshorm
on
Gen
otropin
j
Humatropej
Norditropin
j
Verschieden
eZubereitungen
(EinmalspritzeundPen
)
Wachstumshorm
onman
gel
(GHD)des
Erwachsenen
undKindern
Pharmacia/Pfizer
Lilly
Novo
Nordisk
Wachstumshorm
on
Saizen
j
Zomacton
j
Granditropin
j
Verschieden
eZubereitungen
Hyp
ophysarer
Kleinwuchs
Serono
Ferring
Grandis
DDAVP(Desmopressin)
Minirin
jRhinyle,
Nasen
spray,
Tbl.a0,2mg
Diabetes
insipidus
Ferring
GnRH
Lutrelef
jAmp.a0,8mgund3,2mgzur
pulsatilenTh
erap
ie
Hyp
othalam
ischer
Hyp
ogonad
ismus
Ferring
Gon
adotropine
hMG
oextraktiv
hCG
Men
ogon
j
Choragon
j
75I.E.
FSHund75
I.E.
LH
1500
und50
00I.E./Amp.
Seku
ndarer,hyp
ogonad
otroper
Hyp
ogonad
ismus
Ferring
Ferring
FSH
oreko
mbinan
tLH
Gonal
j
Luverisj
5,5lg,33
lgund77
lg/Amp.
75I.E../A
mp.
Seku
ndarer,hyp
ogonad
otroper
Hyp
ogonad
ismus
Vorneh
mlichbei
,
Serono
Serono
Testosteronen
antat
TestovironDep
otj
250mg/Amp.
Hyp
ogonad
ismus,F
Schering,Jenap
harm
Testosteronundekan
oat
Andriolj
Tabl.a40
mg
Hyp
ogonad
ismus,F
Organ
on
Testosteronundekan
oat
Neb
ido
j10
00mg/Amp.
Hyp
ogonad
ismus,F
Jenap
harm
Testosteron-Pflaster
Androderm
2,5mg/Pflaster
Hyp
ogonad
ismus,F
AstraZen
eca/Promed
Testosteron-Gel
Androtop
j,Testogel
j25
und50
mg/Btl.
Hyp
ogonad
ismus,F
Solvay/Jen
apharm
Ostradiol
Estrifam
j,Estrifam
fortej
1mgund2mg/Tbl.
Hyp
ogonad
ismus,,
Novo
Nordisk
Ostradiol-valerat
Progyn
ova
(mite)
j(1
und)2mg/Tbl.
Hyp
ogonad
ismus,,
Schering
Gestagen
,z.B.MPA
Clin
ofem
jTb
l.a2,5,
5und10
mg
Ovarialinsuffizienz
Pharmacia/Pfizer
Kombinationspraparat
Estrad
iolvalerat/M
PA
Sisare
j2mgund2mg+10
mg
Ovarialinsuffizienz
Organ
on
8 · Anhang207 8
.Ta
belle
A2.
(Fortsetzung)
Praparat
Han
delsnam
eDarreichungsform
Indikation
Hersteller
Nebennierenrinden-Hormon
e
Kortisol
Kortisonacetat
Prednison/Prednisolon
DHEA
9aFluorHyd
rocortison
Hyd
rocortison
j
CortisonCIBA
j
Decortin
j,Decortin
Hj
DHEA
-Natrol
Astonin
Hj
Tbl.a10
mg
Tbl.a25
mg
Tbl.a5,
10,2
0und50
mg
Tbl.a50
mg
Tbl.a0,1mg
NNR-Insuffizienz
NNR-Insuffizienz
NNR-Insuffizienz
NNR-Insuffizienz,(,)
NNR-Insuffizienz
AventisundJenap
harm
Novartis
Merck
Natrol,Bezugau
sdem
Auslan
d
Merck
L-Th
yroxin
L-Th
yroxinHen
ning
j
Euthyroxj
300lg
Tbl.a25
–20
0lg
Tbl.a30
0lg
Hyp
othyreo
se
Hyp
othyreo
se
Hen
ning-San
ofi
Merck
Carbam
azep
inTegretalj
Tbl.a20
0mg
PartiellerDiabetes
insipidus
Novartis
208 Kapitel 8 � Anhang
8
.Ta
belle
A3.
Med
ikam
ente
zurBeh
andlungder
hyp
othalam
isch-hyp
ophysaren
Horm
onmeh
rsekretion
Praparat
Han
delsnam
eMen
ge
Applika-
tionsart
Ublicher
Dosierungsbereich
Indikation
Hersteller
Dop
aminag
onisten
Bromocriptin
Pravidel
jTb
l.a2,5mgund5mg
p.o.
1,25
–10
mg/Tag
Hyp
erprolaktinam
ie/
Prolaktinom,Akromeg
alie
Novartis
Bromocriptin
Kirim
jTb
l.a2,5mgund5mg
p.o.
1,25
–10
mg/Tag
Hyp
erprolaktinam
ie/
Prolaktinom
Horm
osan
Lisurid
Dopergin
jTb
l.a0,2mg
p.o.
2-bis3-mal
0,2–0,4mg/Tag
Hyp
erprolaktinam
ie/
Prolaktinom,Akromeg
alie
Schering
Quinag
olid
Norprolacj
Tbl.a75
–15
0lg
p.o.
1-mal
75lgbis60
0lg/Tag
Hyp
erprolaktinam
ie/
Prolaktinom,Akromeg
alie
Novartis
Cab
ergolin
Dostinex
joder
Cab
aserilj
0,5mg(Dostinex
j)und
1mg(Cab
aserilj)
p.o.
0,5mg/W
ochebis
1mg/Tag
Hyp
erprolaktinam
ie/
Prolaktinom,Akromeg
alie
Pharmacia/
Pfizer
Metergolin
Liserdolj
Tbl.a4mg
p.o.
4–16
mg/Tag
Maß
igau
sgep
ragte
Hyp
er-
prolaktinam
ie
Wyeth
Pergolid
(Parko
tilj)undDihyd
roergocryp
tin(Alm
irid
j)sindin
Deu
tschlandnurzurTh
erap
iedes
MorbusParkinsonzugelassen
Somatostatinan
alog
a
Octreotid
Sandostatin
j50
lg,10
0lgund
500lg/Amp.
s.c.
3-mal
50–50
0lg/Tag
Akromeg
alie,GEP
-Tumoren,
TSH-produzieren
der
Tumor
Novartis
Octreotid
Sandostatin-
LARj
10mg,20
mgund
30mg/Amp
i.m.
10–30
mg/M
onat
Akromeg
alie,GEP
-Tumoren,
TSH-produzieren
der
Tumor
Novartis
Lanreotid
Somatulin
ej30
mg/Amp.undals
Autogel
60,90und12
0mg
i.m.
unds.c.
(Autogel)
30mgalle
7–14
Tageoder
120mgalle
6Wochen
Akromeg
alie,GEP
-Tumoren,
TSH-produzieren
der
Tumor
Ibsena
Wachstum
shormon
antago
nist
Peg
visoman
tSo
mavertj
10mg,15
mgund
20mg/Amp.
s.c.
Startdosis:80
mg
Gefolgtvo
n10
–30
mg/Tag
Therap
ieresisten
teAkrome-
galie
Pharmacia/
Pfizer
8 · Anhang209 8
.Ta
belle
A3.
(Fortsetzung)
Praparat
Han
delsnam
eMen
ge
Applika-
tionsart
Ublicher
Dosierungsbereich
Indikation
Hersteller
Adrenolytika
Ketoconazol
Metyrap
on
Aminoglute-
thim
id
Mitotan
Nizoralj
Metopiron
j
Orimeten
j
Lysodren
j
Tbl.a20
0mg
Tbl.a75
0mg
Tbl.a25
0mg
Tbl.a50
0mg
p.o.
p.o.
p.o.
p.o.
2-bis3-mal
200mg/Tag
4-mal
750mg/Tag
2-bis3-mal
250mg/Tag
0,5–9,0g/Tag
Therap
ieresisten
tes
Cushing-Syn
drom
Therap
ieresisten
tes
Cushing-Syn
drom
Therap
ieresisten
tes
Cushing-Syn
drom,
NNR-Karzinom
Jansen-Cilag
Novartisa
Novartis
Bristol-Myers-
Squibba
GnRH
-Ago
nisten
Goserelin
Zoladex
j3,6mg/Amp.
i.m.
1-mal/M
onat
Pubertaspraecoxvera
Astra
Zen
eca
Leuprorelin
Enan
tonej
3,57
mg/Amp.
i.m.
1-mal/M
onat
Pubertaspraecoxvera
Takeda
Triptorelin
Decap
eptylj
3,75
mg/Amp.
i.m.
1-mal/M
onat
Pubertaspraecoxvera
Ferring
Andere
Pharmaka
Valproinsaure
Orfirilj
150mg�6
00mg/Tbl.
p.o.
3-mal
300mg/Tag
Cushing-Syn
drom
Desitin
Dem
eclocyclin
Ledermycin
j15
0mgund30
0mg/Tbl.
p.o.
2-mal
300mg/Tag
SIADH
Lederle
a
Cyp
roteron
Androcurj
10mgund50
mg/Tbl.,
300mg/Amp.
p.o.,i.m.
10–50
mg/Tag
,30
0mg/
Monat
PubertaspraecoxF
Schering
TRIAC
Teatrois
j0,35
mg/Tbl.
p.o.
1Tb
l./Tag
Zen
traleSD
-Horm
on-
resisten
z
Lab.DB
Pharmaa
aNurau
sdem
Auslan
dbeziehbar.
210 Kapitel 8 � Anhang
8
. B Datenbanken und sonstige Informationsquellen Stand: Herbst 2004
Name Anschriften/Internet-Adressen
Deutsche Gesellschaft fur Endokrinologie
(DGE)
Geschaftstelle: Burkle de la Camp-Platz 1, D-44789 Bochum
Tel.: 02 34-9 78 89 30, Fax: 02 34-9 78 89 31
www.endokrinologie.net
European Neuroendocrine Association
(ENEA)
President: Prof. Ashley Grossman
St. Bartholomew’s Hosp. West Smittfield, London EC1A 7BE, UK
Arbeitsgemeinschaft Hypophyse der DGE c/o Prof. Dr. med. H.-J. Quabbe, Auguststr. 18, D-12209 Berlin
European Federation of Endocrine Societes
(EFES)
Regus Park Atrium, 11 Rue des Colonies, B-1000 Bruxelles, Belgique
Tel.: 00 32-2 517 71 07, Fax: 00 32-2 517 65 00
The Endocrine Society 8401 Connecticut Avenue, Suite 900, Chevy Chase, MD 20815-5817,
USA
Tel.: 001-301-941-0200, Fax: 001-301-941-0259
www.endo-society.org
British Society for Endocrinology www.endocrinology.org
Netzwerk fur Hypohysen- und Neben-
nierenerkrankungen e. V.
Waldstraße 34, D-91054 Erlangen Tel.: 0 91 31-81 50 46,
Fax: 0 91 31-81 50 47
www.glandula-online.de
Internationale Selbsthilfegruppen
Pituitary Network Association (USA)
(PNA)
PO Box 1958, Thousand Oaks, CA 91358, USA, Tel.: 001-805-499-9973
www.pituitary.org
Die Druse (Osterreich) Jakob Wurmback, Eichenstraße 1, A-2521 Trumau
Schweizer Selbsthilfegruppe fur Krank-
heiten der Hypophyse
Wegweiser (Schweiz)
Arnold Forter, Postfach 529, CH-3004 Bern
Morbus Addison Foreningen I Danmark
(Danemark)
Jette Kristensen, Grenaavej 664 G, DK-8541 Skoedstrup
www.addison.dk
Nederlandse Vereniging voor Addison
en Cushing Patienten
(NVACP) (Niederlande)
Postbus 52137, NL-2505 CC Den Haag
www.nvacp.nl
Hypophysis (Schweden) Sandhult PL 801, S-28040 Skanes Fagerhult
www.come.to/hypophysis
8 · Anhang211 8
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TSH-, Gonadotropin-, a-Subunit-produzierende Tumoren
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Melmed S, Ezrin C, Kovacs K, Goodman RS, Frohman -LA (1985) Acromegaly due to secretion of growthhormone by an ectopic pancreatic islet-cell tumor.N Engl J Med 312: 9 – 17
Phillips LS, Robertson DG (1993) Insulin-like growthfactors and non-islet cell tumor hypoglycemia. Me-tabolism 42: 1093 – 1101
Schwartz WB, Bennett W, Curelop S, Bartter FC (1957)A syndrome of renal sodium loss and hyponatremiaprobably resulting from inappropriate secretion ofantidiuretic hormone. Am J Med 23: 529
Ulick S, Wang JZ, Blumenfeld JD, Pickering TG (1992)Cortisol inactivation overload: A mechanism of mi-neralocorticoid hypertension in the ectopic adreno-corticotropin syndrome. J Clin Endocrinol Metab 74:963 – 967
Wajchenberg BL, Mendonca BB, Liberman B, Alberg-aria Pereira MA, Campos Carneiro P, Wakamatsu A,Kirschner MA (1994) Ectopic adrenocorticotropichormone syndrome. Endocrine Review 15: 752 – 787
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Weitere Literaturstellen sind unter Akromegalie undCushing-Syndrom aufgefuhrt, insbesondere die Dif-ferenzialdiagnose zwischen eutoper und ektoperHormonproduktion betreffend.
222 Kapitel 9 � Literatur
9
Sachverzeichnis
10
5-Hydroxytryptamin 2011-b-Hydroxysteroid-Dehydrogena-se 164
Aa-Fetoprotein 81a-MSH 22, 36, 200a-Subunit (a-SU) 38, 40, 136, 182
Bestimmung 55Spiegel 184f/TSH-Quotient 182f
Abstillen 49Acanthosis nigricans 142AcCholin 23, 26Acid labile subunit (ALS) 46ACTH 36, 38, 55
Bestimmung 55Kortisol-Sekretion 39Mangel 96, 98Resistenz 35Rezeptor 35Sekretion 25, 30, 44, 162Sekretion, ektope 163f, 180Spiegel 21, 31, 35, 57, 96f, 168f, 176f,202
Suppression 21Syndrom, ektopes 104, 166, 169ff,172f, 193
Syndrom, ektopes, CRH-Stimula-tionstest 170
Test 57, 59Adenom 72
ACTH-sezernierendes 34, 102, 159,162ff, 166, 168ff, 173, 176f, 179, 181,190, 192
ACTH-sezernierendes, transspeh-noidale Operation 175
adrenales 174chromophobes 72FSH-produzierendes 186Glykoproteidhormon-produzie-rendes 181f
gonadotrophes 190Gonadotropin-produzie-rendes 186
Gonadotropin-sezernierendes 102Gsp-negatives 139Gsp-positives 139kortikotrophes 190LH-produzierendes 186Makro- 76, 102, 109Makro-, GH-produzierendes 134Mikro- 102, 109, 158Nicht aktives (NFA) 190somatomammotrophes 136, 144somatotrophes 135, 139, 190TSH-produzierendes 182, 190TSH-sezernierendes 181a-Subunit-produzierendes 181
Adenomresektion 129Adenomzelle 106Adenylatzyklase (siehe Adenylzy-klase)
Adenylzyklase 18f, 40, 139Adenylzyklase, konstitutionelle Sti-mulation 138
ADH 27, 33Bestimmung 56
Resistenz 98fRezeptor 33Sekretion 62Sekretion, ektope 195Sekretion, Regulation 34Spiegel 34Wirkung 34
Adrenalektomie 192bilaterale 174, 176, 180unilaterale 179
Adrenokortikotropes Hormon (sieheACTH)
Adrenolytika 192, 210Adrenolytisches Medikament 176,190, 192, 210
Adrenolytische Therapie 179fAgouti-Protein 22f, 31Akrenvergroßerung 142Akromegalie (siehe auch Gigantis-mus) 2, 26, 28, 102ff, 134ff, 139, 141,142, 146, 148f, 152, 155ff, 182, 190, 192,194, 209endokrinologische Funktions-diagnostik 145
familiare 134Inzidenz 135kardiale Manifestation 143Pravalenz 135Symptomatik 142Therapie 157Todesursache 144transsphenoidale Operation 136transsphenoidale Operation,Remissionsraten 147
TRH-Test 137Akromegalis-Hyperprolaktamie 159Akromikrie 90Aktivin 41
A 40AB 40B 40
Albright-Syndrom 199Alkohol, endokrine Effekte 202Amenorrho 28, 108f, 126, 142, 165, 186
primare 114sekundare 114Galaktorrho-Syndrom 185
Amnionflussigkeit 48Amnion-PRL 48Amphetamin 25Androgensubstitution 95Angiotensin 33Anorexia nervosa 200Anovulation 194
ektope LH-Bildung 194hyperprolaktinamische 51postpartale 49
Anovulatorische Zyklen 108Antidepressiva 202Antidiuretisches Hormon (sieheADH)
Aquaporin 33Aquaporin-2 99Arachnoidalzyste 76, 187Arginin 24
Infusionstest 60Vasopressin (AVP) 28, 33, 62, 98,100
Arthropathie 142
Atrialer natriuretischer Faktor(ANF) 33
Auslassversuch, DA-Therapie 131Azoospermie 181
Bb-Endorphin 31, 35ffb-hCG 80f, 104b-hCG-Serumspiegel 43b-Lipotropin (siehe b-LPH)b-LPH 31, 35f, 36b-Rezeptorenblokade 23Basaltemperatur 41Begleithyperprolaktinamie (sieheauch Pseudoprolaktinom) 111, 136,144f
Benzodiazepin 25, 202Bestrahlung 127, 130, 146, 157
externe 133Bromocriptin 111, 117ff, 121ff, 126f,130, 132, 149, 182, 185, 191, 209Behandlung 148Intoleranz 119Nebenwirkung 120Therapie 148fUnvertraglichkeit 120
Bulbus olfactorius 93
CCabergolin 117ff, 121, 123f, 132, 149,159, 191, 209Nebenwirkung 120
Cafe-au-lait-Flecken 72, 134Carbamazepin 101Carney-Komplex 73, 84, 134, 162, 174Carter-Robbins-Test 62fChiasma opticum 9, 70, 74
Syndrom 107, 139, 181Chlorpromazin 23Chordom 80ffChoriongonadotropin 40, 104Chorionkarzinom 81, 194Chorionsomatomammotropin 43
humanes (hCS) 47Circulus arteriosus Wilisii 190CLIP 38Clomifen 57
Test 60Clonidin 136, 202
Test 60Computertomographie 63Corpora lutea 41Corpus-luteum-Insuffizienz 108Corticotropin Releasing Faktor(CRF) 4
CREB 18fCRH 27, 30
Plazenta 30Schwangerschaft 30ACTH-NNR-Achse 20Halbwertszeit 30Mangel 96Mehrsekretion 163Plasmaspiegel 30Sekretion, ektope 164, 180Stimulationstest 169, 175, 177Stimulationstest, ektopes ACTH-Syndrom 170
224 Kapitel 10 � Sachverzeichnis
10
Syndrom, ektopes 171Test 97, 172, 192
Cushing 2f, 103Cushing-Syndrom 103, 159ff, 165ff,171, 174, 179f, 193f, 210ACTH-Spiegel 169adrenolytische Behandlung 180Alkohol-induziertes 202Diagnostik 167fmedikamentose Therapie 176paraneoplastisches (siehe ACTH-Sekretion, ektope)
Striae rubrae 166Symptome 165therapeutische Strategie 179Therapie 174Ursachen 161
Cyproheptadin 24fCytochrom P 450 35
DD2-Rezeptor 121DA 26ff, 40, 49f, 106DA-Agonist 28, 45, 50, 108, 117, 120f,123, 126f, 129f, 148, 156f, 178, 183f,190ff, 209Aquivalenzdosis 118Behandlung 123, 131Nebenwirkung 119Resistenz 130, 132Therapie 5, 23, 109, 111f, 124, 129,150
DA-Antagonist 23, 26, 104, 116, 202Darmhormon-Peptid YY 23Dawn-Phanomen 45DAX1-Gen 91DDAVP 34, 170, 207
Minirin 100Test 60
Dehydroepiandrosteron (DHEA) 86,96
Depression, endogene 165Desmopressin (siehe DDAVP)Dexamethason 35, 57, 181, 206Dexamethasonhemmtest 168, 180Dexamethasonkurztest 167Dexamethasonsuppression 162, 172Dexamethasonsuppressionstest(DST) 165
Diabetes insipidus 4, 33, 60, 62, 70,80, 82, 86f, 98ff, 190, 198, 203dipsogener 98renaler 99zentraler 99f
Diabetes mellitus 45Diagnostik, ophthalmologische 64Diaphragma sellae 8Diathese, hamorrhagische 165Dihydrotestosteron (DHT) 43Dimerisierung 19Dopamin (siehe DA)Doppelgoldfarbung 11Durstversuch 60, 62, 100Durstzentrum 99f, 198Dysgerminom 80, 112, 187Dyshormonogenese 69
EElektrolytstorung 84Eminentia mediana 9ff, 18, 29ff, 81Empty-Sella-Syndrom 78fEndokrinologische Funktionsdia-gnostik 56
Endorphin 21, 33, 35Endothelin 12Enkephalin 21, 33, 35Ependymom 80Epidermoidzyste 80Erkankung, zerebrovaskulare 146
kardiovaskulare 146Estradiol 43
Spiegel 41Expansion, klonale 73
FFeedback, negativer 20
positiver 42Fertiler Eunuch 91Fettsucht, stammbetonte 165Follicular stellate cells 12Follikelphase 40fFollikelstimulierendes Hormon(siehe FSH)
Foramen-Monroi-Blockade 107fFSH 36
Bestimmung 55Spiegel 42, 57
Gc-MSH 35G-Protein 17ff, 69Gs-Protein 21, 101, 138Gs-Proteinmutation 105Gain of function 19, 69, 84Galaktorrho 80, 103, 108, 114ff, 130,142, 187
Galaktorrho-Amenorrho-Syndrom 2
Gamma knife 147f, 189Gammaaminobuttersaure(GABA) 21, 24
Gastric inhibitory polypeptide(GIP) 162
Gelenkerkrankung, akromegale 143Gesichtfeld 129Gesichtsfeldausfall 80, 107, 115, 139,142
Gesichtsfelddefekt 70, 74, 76, 82, 155Gesichtsfeldeinschrankung 108, 125GH 23, 37, 43, 48, 154
Bestimmung 56biosynthetisches 86plazentares 47Antagonist 47, 152f, 155, 157, 190IGF-1-Achse 89, 202Immunoreaktivitat 43Insensitivitatssyndrom 89Mangel 74, 80, 82, 88f, 90PRL-Zytokin-Rezeptorfamilie 47Resistenz 200Rezeptor 18Rezeptordefekt 88Sekretion 32, 44fSerumspiegel 45
Spiegel 43, 57, 89, 135, 137, 139, 147f,156
Spiegel, postoperativer 146Spiegel, praoperativer 146Syndrom, ektopes 134Wirkung 45
Ghrelin 5, 22f, 31, 45f, 199GHR-Dimerisierung 155GHRH 24, 26, 31, 43, 45
Bestimmung 145Mangel 88Produktion, ektope 135, 154Produktion, eutope 135Rezeptor 31Sekretion 47Sekretion, ektope 152Sekretion, endogene 136Syndrom, ektopes 31, 134, 151, 193Syndrom, eutopes 134Syndrom, ektopes 145Test 136f
GHS 31, 45, 91Peptid 46
Gigantismus (siehe auch Akromega-lie) 103, 134, 198
Glucagon 33Glukokortikoid 202f
Langzeittherapie 203Glukosebelastung, orale 44, 57, 60,145
Glukosetoleranz 141Glykoproteidhormon 36, 181fGnRH 4, 26, 28ff, 42
Agonist 210Analoga 28, 187assoziiertes Peptid (GAP) 30, 32Freisetzung, pulsatile 187Pulsatilitat 25, 33, 115Substitution 95Therapie 92, 126, 128Therapie, pulsatile 93f
Gonadotropin 40, 207Meopausen- 42Releasinghormon (siehe GnRH)behandlung 94mangel, Erwachsenenalter 93mangel, Kindesalter 91Sekretion 21, 25Spiegel 41, 55Substitution 95
Granula, sekretorische 72Granulom 112
eosinophiles 82Granulomatose Erkrankung 82Graviditat 45Growth factors 16, 18Growth hormone (siehe GH)
binding protein (GHBP) 18, 43, 47deficiency (GHD) (siehe GH-Mangel)
Releasinghormon (siehe GHRH)Sekretagoga (siehe GHS)
gsp-Onkogen 72Guanosindiphosphat (GDP) 17Guanosintriphosphat-(GTP-)Kom-plex 17f
Gynakomastie 93f, 103, 115, 194, 199
10 · Sachverzeichnis225 10
HHalbwertszeit 43Hamartom 80, 82
hypothalamisches 187Hamochromatose 83Hande, fleischig und teigig 142Hashimoto-Thyreoiditis 78hCG-Test 60Hemianopsie, bitemporale 107Hexarelin 31HHL-Hormon 34HHL-Insuffizienz 79High-dose-hook-Effekt 111fHirsutismus 165fHistiozytose 99
X 82HIV-Infektion 83hMG 42Hodentumor (Teratom) 42Hodenvolumen 92Hodgkin-Erkrankung 99, 112Hormon, gastrointestinales 33
hypophysiotropes 26ff, 69neurohypophysares 27somatotropes (STH) 43antikorper 54bestimmungen 54rezeptor 16, 18spiegel 57substitution, Ostrogen-Gestagen-Praparate 94
syndrom, ektopes 103, 193fHoussay-Phanomen 2, 45Human placental lactogen (hPL) 47Hungerhormon (siehe Ghrelin)HVL, hypothalamische Steuerung 4
Adenom, TSH-produzie-rendes 192
Hormonausfall, Pravalenz 74Hormonexzess, Basis-diagnostik 65
Hormonsekretion 23Insuffizienz 69f, 73, 80, 84, 181Insuffizienz, komplette 97
Hydrocephalus 107Hydrokortison 86Hyperhidrosis 142Hyperinsulinismus 46Hyperkortisolismus 97, 160, 162, 166,174, 202Remission 175
Hypernatriamie 100Hyperpigmentation 96Hyperplasie 73
laktotrophe 48makronodulare 160, 173mikronodulare 160
Hyperprolaktinamie 28, 70, 76f, 80,82, 102, 104, 107, 110, 112ff, 120, 122f,134, 142, 187, 191f, 198, 209Behandlung 121Diagnostik 116Medikamente 113physiologische 104
Hyperprolaktinamische Sterilitat 125Hyperthyreose 103
zentrale 102, 192Hypertrichosis 140, 142Hypoglykamie 196
Insulin-induzierte 44Hypogonadismus 28, 73f, 80, 84, 87,90, 93, 102, 142, 165, 181, 194, 198fErwachsene 93hyperprolaktinamischer 113f, 116,132, 159
hypogonadotroper 91Kinder 91primarer 42
Hyponatriamie 84, 190, 194fHypophysares Koma (siehe Hypo-physeninsuffizienz, akute)
Hypophyse 46, 99Adeno- 10Neuro- 10, 12, 18Rachendach- 13
Hypophysenadenom 72f, 76f, 88,101f, 105, 172, 187, 189ACTH-produzierendes 159Autopsie 188endokrin aktives 101FSH-produzierendes 181Glykoproteid-Hormon produzie-rendes (siehe Thyrotropin)
Gonadotropin-produzie-rendes 181
hormoninaktives 72LH-produzierendes 181PRL-produzierendes 185Therapieverfahren, Zusammen-fassung 189
thyrotrophes, Schrumpfung 184transsphenoidaler Eingriff 189TSH-produzierendes 184f
Hypophysenapoplexie 84, 109, 125,129, 191
Hypophysenbestrahlung 147, 176,189
Hypophysenerkrankung, Diagnose 5Hypophysenhinterlappenhormon 33Hypophysenhormone, Bestim-mung 55f
Hypophysenhormonausfalle, Dia-gnostik 65
Hypophysenhypoplasie 13Hypophyseninsuffizienz 83
akute, Therapie 88Therapie 86
Hypophyseninzidentalom 102, 187Hypophysenkarzinom 74ff, 102
Metastase 75Hypohysennekrose, postpartale(siehe auch Morbus Sheehan) 83
Hypophysenoperation 179, 191ftranssphenoidale 145
Hypophysenstiel 8f, 13, 16, 69, 76, 79Hypophysenstielabriss 83Hypophysenstieldurchtrennung 112Hypophysentumor 2, 5, 70, 135, 139
ACTH-produzierender 155Operation 5Schwangerschaft 191TSH-produzierender 183Apoplexie 78
Hypophysenvolumen 8, 48, 193Hypophysenvorderlappen-hormon 34
Hypophysenvorderlappeninsuffizi-enz 85, 148
Hypophysitis 77f, 82, 84, 96, 98postpartale 85
Hypothalamische Adipositas 198Hypothalamische Raumforde-rung 71, 79
Hypothalamischer Prozess 198Hypothalamischer Tumor 70Hypothalamisch-hypophysareEinheit 9Erkrankung, Diagnostik 206Hypothalamisch-hypophysare In-suffizienz 69
Hypothalamisch-hypophysarer Min-derwuchs 83
Hypothalamisch-hypophysaresTumorsyndrom 70
Hypothalamus 2, 10f, 14, 18, 20f, 26,30, 33, 42, 46, 50, 99, 101, 112, 202Hypophysen-Achse (HHA) 23Hypophysen-Achse, Immunsys-tem 23
Hypophysen-Funktion 202Hypophysen-NNR-Achse 203
Hypothyreose 43, 45, 74, 78, 87, 104,184, 194primare 114sekundare 74, 84, 96
IIGF-1 46
Bestimmung 56, 145, 156Produktion 155Rezeptor 47Spiegel 47, 57, 88ff, 139, 141, 144,147, 153, 157, 200
Spiegel, Korrelation zu glukose-supprimierten GH-Spiegel 147
IGF-2 196IGF-binding protein (IGFBP) 46IGFBP-3 46
Bestimmung 56Spiegel 90
Immunhistologie 11Immunoassay (IA) 55fImmunofunktionelle Methode 54Immunometrischer Assay (IMA) 55Inappropriate Sekretion vonantidiuretischem Hormon (sieheSIADH)
Inhibin-A 40ffInhibin-B 40ffInhibinspiegel 41Inhibitinghormon 4Inositolphosphat 29Insulin like growth factor (IGF) 18Insulin like growth factor 1 (sieheIGF-1)
Insulinhypoglykamie 57, 136Test (IHT) 58fTest, Kontraindikation 58
Insulinresistenz 46Interleukin 12, 20fInterstitial cell stimulating hormone(ICSH) 37, 43
Inzidentalom 170, 187f
JJanuskinase 2 18f
226 Kapitel 10 � Sachverzeichnis
10
KKalig-I-Gen 91Kallmann-Syndrom 91, 93Kardiomyopathie 141
akromegale 143Karpaltunnelsyndrom 140, 142Karzinoid 135, 152, 172, 179Karzinom, adrenales 174Kasein 48Keimzelltumor 80
nichtgerminomatoser(NGGCT) 81
Kernspintomographie 5, 63, 108, 116f,123, 127, 172, 187, 192
Kleinwuchs 43, 88ff, 199Klinefelter-Syndrom 199Knochendichte 89fKnochenmassenverlust 116Kokain- und Amphetamin-reguliertes Transkript (CART) 22
Kolonpolyp 141Kopfschmerz 140, 142Kortikotrophinom 159, 162f, 171, 181,184
Kortikotropin-Releasinghormon(siehe CRH)
Kortisol, freies, 24-h-Urin 167Mitternachts- 167Urin 39
Kortisolmehrsekretion,autonome 168
Kortisol-Spiegel 21, 30, 57, 96erhohter 165
Kortison 86Kowarski-Syndrom 88Kraniopharyngeom 79ff, 88, 104, 113,187
LLaktation 51Laktomedin 48Lanreotid 150, 209Laron-Syndrom 88fLaurence-Moon-Bardet-Biedl-Syndrom 91, 198f
Leere-Sella-Syndrom (siehe Empty-Sella-Syndrom)
Leptin 21fMangel 199Rezeptor 200
Leukamische Infiltration 82Leydig-Zwischenzellen 41f, 81LH 37
Bestimmung 55Peak, Zyklusmitte 42Sekretion 42Spiegel 42, 57, 92
Libidostorung 108, 142Libidoverlust 116Linac 148Lipotropin (siehe b-LPH)Liquor cerebrospinalis 16Liquorfistel 191Lisurid 117f, 120f, 191, 209
Intoleranz 119Loss of function 19, 69, 84Low-T3-Syndrom 200Lutealphase 41
Luteinisierungshormon (siehe LH)Lymphom 82Lysodren 177
MMakroglossie 142Makroprolaktinom (siehe Prolak-tinom, Makro-)
Makroprolaktinamie 48, 116fMC4R-(MC4-Rezeptor) 22, 200MC4R-Mutation 199McCune-Albright-Syndrom 72, 84,134, 187
Melanozytenstimulierendes Hormon(siehe a-MSH und b-MSH)
MSH-Rezeptor 35MEN-1 73, 84, 123, 134, 141
Gen 72Syndrom 105
Meningeom 80Meningitis 191Metergolin 118, 209Metoclopramid (MCP) 112, 116
Test 60Metopiron 57, 59Minderwuchs 45, 80, 89fMinirin 100Mitternachtskortisol 167Morbus Cushing (siehe Adenom,ACTH-sezernierendes)
Morbus Hodgkin 82Morbus Sheehan 83Mukozele 76f
NNebennierenrinde (siehe NNR)Nelson-Syndrom 164, 184Nelson-Tumor 76, 163, 176Nerve growth factor (NGF) 47, 121fNeurohormon 16f, 26Neurohormon, hypophysio-tropes 18, 33hypothalamisches 28, 103
Neurohypophysitis 78Neuron, magnozellulares 14
neurosekretorisches 10parvozellulares 14tuberoinfundibulares 50
Neuroleptika 202Neuropeptid NPY 23, 31Neuropeptid Y 22Neurophysin 1 33Neurophysin 2 33Neurosarkoidose 79, 82Neurotransmitter 21, 26, 33, 42, 46Neurotransmitterkontrolle 23, 25fNN-Adenom 173NNR 160
Adenom 177, 180Hyperplasie, makronodulare 160,162, 174
Hyperplasie, mikronodulare 162Insuffizienz 22, 35, 74, 85, 87, 96ff,100, 163, 179, 199, 202, 208
Insuffizienz, akute 74Insuffizienz, partielle 203Insuffizienz, sekundare 175, 177Karzinom 166, 176f, 180, 210
Tumor 169Noradrenalin 20ffNucleus arcuatus 21Nucleus paraventricularis 18, 30, 70Nucleus supraopticus 14, 18, 70Nullzelladenom 72, 102
Oo’p’-DDD 177Octreoscan 28, 63, 151, 170, 173Octreotid 132, 150ff, 177, 179f, 184, 193,209Langzeitbehandlung 150Therapie 154
OGTT 144Oligomenorrho 108, 159Operation 127, 145, 191Operation, transfrontal 157
transkranielle 191transsphenoidale 156f, 158f, 175f,180, 184, 191
Operationsmikroskop 5Opiat 202
endogenes 23Rezeptor 25
Organwachstum 139Osmorezeptor 34Osteopenie 116Osteoporose 166
Kortikoid-induzierte 203Ostradiolspiegel 42Ostrogen-Rezeptor 12fOvarial-Insuffizienz, primare (Kli-makterium praecox) 93
Ovulation 41Oxytocin (OT) 27, 33
Bestimmung 56Spiegel 34, 49
PPACAP 12Palisadenzone, außere 10f
innere 11, 18Panhypopituitarismus 81Parlodel LAR 119Pasqualini-Syndrom 91Pegvisomant 5, 47, 153, 155f, 192Peptid, ACTH-abhangiges 35
POMC-abhangiges 35vasoaktives intestinales (VIP) 21
Pergolid 118, 209Peroxisom-Proliferator aktivierterRezeptor-c (PPAR-c) 176ff
Pharmakologische Effekte 202Pharmakotherapie hypophysarerMehrsekretionszustande 5
Phentolamin 23Phosphatspiegel, erhoht bei Akro-megalie 141
Photophobie 141Phylogenese 16Pit-1 12f, 39, 43, 47, 96
Defekt 83Pituitary adenylate cyclase activatingpolypeptide (siehe PACAP)
Pituitary tumour transforming gen(PTTG) 73
Plazentares Lactogen (PL2) 37
10 · Sachverzeichnis227 10
Polydaktylie 199Polydipsie 99
primare 98psychogene 99
Polyphagie 198Polyurie 99fPOMC 11, 13, 22, 30, 35, 38, 72, 177,199fAbkommling 36
Portalgefaßsystem 4, 11, 16Portalsystem 18, 50Positronenemissionstomographie(PET) 63f
Postmenopause 42Post-partum-Nekrose 4Potenzstorung 108, 142Potenzverlust 116Prader-Labhart-Willi-Syndrom 199Praproenkephalin A 38Praproenkephalin B 38Prednisolon 86PRL 26, 37, 47, 50
Makro- 48, 116fphosphoryliertes 48Bestimmung 55Gen 47Nonresponder 138Responder 138Rezeptor 48Sekretion 26, 29, 33Sekretionsgranula 48Spiegel 49, 51, 57, 109ff, 125, 127f,133, 137
Spiegel, basaler 108Progesteron-Spiegel 41Prolaktin (siehe PRL)
Inhibiting-Factor (PIF) 30Inhibitinghormon (PIH) 26f, 32Releasing-Faktor (PRF) 26, 32
Prolaktinom 104f, 109, 120, 148, 152,188, 190f, 209Behandlung 130Makro- 104f, 107f, 110ff, 115, 120,123ff, 126f, 130, 132f, 191
malignes 105, 121, 130Mikro- 104ff, 110, 122, 128, 191operative Therapie 128Schwangerschaft 108, 110PRL-Spiegel 132schrumpfung 125
Proopiomelanocortin (siehe POMC)Genexpression 35Spaltprodukte 35
Prop-1 12, 39, 96Defekt 83
Proteinkinase C 19Pseudo-Cushing, alkohol-induzier-ter 165
Pseudohypoparathyreoidismus 199Pseudoprolaktinom 104f, 110, 112, 136Pubertas praecox 28, 70, 80, 186f, 210Pubertat 47Pygmaen 89
QQuinagolid 117ff, 121f, 124, 127, 132,149, 209
RRadiatio 192
fokussierte 133Radiochirurgie (siehe gamma knife)Radioimmunoassay 56Radiotherapie 81, 129, 131, 147, 176,179f, 190fokussierte 74, 133konventionelle 74Remission 148
Rathke-Tasche 12fRathke-Zyste 76Regelmechanismen 20Releasinghormon 4, 101, 206
Produktion, ektope 104Test 61
Resistenz 120Rezeptor 18
GHRH/TSH 19G-Protein-gekoppelter 29, 32, 35,40
Insulin/IGF-1 19Leptin- 22Melanokortin-4- 22transmembranoser 19Tyrosinkinase- 19Zytokin/GH/PRL 19bindungsstelle 154defekt (siehe auch loss offunction) 69
dimerisierung 47expression, ektope 168
Rhythmus, endogener 44zirkadianer 35, 39
Riesenwuchs 2, 45Riesenzelltumor 82
SSalidiuretika 101Sandostatin LAR 150f, 156, 159, 209Sarkoidose 98f, 104Saugreiz 51Schwangerschaftsadenom 106Schilddrusenhormon 29
Resistenz 183fSchlafapnoe 142Schlaf-Wach-Rhythmus 198Schwangerschaft 49f, 104, 108ff, 131f,191, 193PRL-Spiegel 111
Schwangerschaftsadenome 106Schwartz-Bartter-Syndrom 103, 194Seborrho 116Sekretion, autokrine 16
parakrine 16Sella turcica 8, 10, 79, 93, 107, 110Sellavergroßerung 142Serotonin 23f, 26Sertolizelle 42Serumosmolalitat 100SHBG-Spiegel 185Sheehan-Syndrom 4, 78, 83f, 93SIADH 190, 194f, 202f, 210Signaltransducers und Aktivator furTranskription (STAT) 18f
Signaltransduktion 19, 154Signalubertragung 16Sinus cavernosus 8f, 132, 159
SOM-230 150Somatomedin C 46Somatopause 47, 89Somatostatin GHRIH (GH-release-Inhibiting-hormon) 4, 24, 27f, 32,40, 45f
Somatostatin, Mini- 32Somatostatinanaloga 5, 149ff, 156,177, 183, 189f, 192f, 209
Somatostatinom 103Somatostatin-Rezeptor 150f, 170, 177
Liganden (SRL) 150, 157Szintigraphie (siehe Octreoscan)
Somatotropin (siehe GH)Spermatogenese 41Spermiogenese 42Standardhormonpraparation 54STAT-Protein 19, 89Sterilitat, weibliche 191Sterilitatsbehandlung 126, 193Steroidbiosynthese 35Stillen 50Stillzeit 49Stimulationstest 57Strahlentherapie 5, 193
fokussierte 76Stress 45Striae rubrae 165fStruma nodosa 141Subarachnoidalblutung 83, 125, 191Substitutionstherapie 5, 97Suppresionstest 57, 60Supraorbitale Wulste 142Synacthen 59, 206
Test 96, 180Syndrom der inappropiaten ADH-Sekretion (siehe SIADH)
Synlaktin 48
TTagesrhythmus 44, 55, 202Tagesschwankungen 51Tag-Nacht-Rhythmus 55Tanizyten 10, 16Tannenbaum-Phanomen 166Ternarer Komplex (ternaryKomplex) 46
Temperaturregulationsstorung 199Teratom 42Tergurid 118fTestosteron (T) 42f, 92, 207
Gel 95Spiegel 57
Testosteronenanthat 95Testosteron-Membran-Pflaster 95Testosteronundekanoat 95, 207Therapie, medikamentose 148Thyreoglobulin 40Thyreoidea-stimulierendes Hormon(siehe TSH)
Thyrotropin (siehe TSH)Releasinghormon (siehe TRH)
Thyroxin-Spiegel 57TIDA-Neuron 105TNFa 21Tractus supraoptico-hypophysia-lis 10, 14, 18
Tractus tubero-infundibularis 10
228 Kapitel 10 � Sachverzeichnis
10
Transforming growth factor(TGF) 47
Transsexualitat 107Transskriptionsfaktor 12ffTRH 4, 27
Mangel, endogener 96Test 137
TRIAC 183, 210TSH 36, 38, 102
Bestimmung 55Mangel (siehe auch sekundareHypothyreose) 96
Neugeborenen-Screening 40Sekretion 21, 26, 29, 32fSekretion, TRH-stimulierte 25, 40Spiegel 29, 40, 57b-Kette 39
Tuberkulose 79, 82Tuberoinfundibulares dopaminergesNeuron (TIDA) 26, 32
Tumor, Gsp-negativer 139Gsp-positiver 136, 138monoklonaler 73somatomammotropher 145TSH-produzierender 185, 209Wachstumsfaktor 73
genese 73hypoglykamie, Nicht-Inselzell-assoziierte 194f
metastasen 70nekrosefaktor 20schrumpfung 123, 127, 151
Turkensattel (siehe Sella turcica)Tyrosinkinase 18f
UUberfunktion (siehe auch gain offunction) 69
Untersuchung, elektronenmikrosko-pische 11
VVasopressin (siehe ADH)VIP 29, 32f, 50Viszeromegalie 141f
WWachstumshormon (siehe GH)Weltgesundheitsorganisation(WHO) 54
Wegener’sche Granulomatose 79, 82
Weichteilschwellung 143WHI-(women health initiative-)Studie 93
Wolf-Chaikoff-Effekt 184
ZZelle, azidophile 11
basophile 11chromophobe 11gonadotrophe 11, 13, 187kortikotrophe 13, 97f, 163, 177laktotrophe 11ff, 48, 50, 105, 108laktotrophe, densely granu-lated 106
somatomammotrophe 11fsomatotrophe 11ff, 43, 48thyrotrophe 11ff
Zellmembran 46Zona glomerulosa 97
fasciculata 96reticularis 96
Zyklusstorung 74Zystizerkose 79, 82Zytokine 16, 18, 21Zytokin-PRL-Wachstumshormonre-zeptor-Superfamilie 18f, 48
10 · Sachverzeichnis229 10
