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Title: ホルモン補充療法に伴う前立腺の容積変化を観察しえた低ゴナドトロピン型性腺機能低下症の1例
Other Titles: A case report of idiopathic hypogonadotropic hypogonadism with particular reference to monitoring of prostate volume
Authors: 平山, きふ  KAKEN_name
岡田, 晃一  KAKEN_name
兼光, 紀幸  KAKEN_name
小島, 宗門  KAKEN_name
早瀬, 喜正  KAKEN_name
Author's alias: Hirayama, Kifu
Okada, Koichi
Kanemitsu, Noriyuki
Kojima, Munekado
Hayase, Yosimasa
Keywords: Hypogonadotropic hypogonadism
Transrectal ultrasonography
Issue Date: Jul-2004
Publisher: 泌尿器科紀要刊行会
Journal title: 泌尿器科紀要
Volume: 50
Issue: 7
Start page: 501
End page: 504
Abstract: 23歳男性.患者は第2次性徴欠如で受診した.陰毛はなく,両側精巣は強く萎縮し,直腸診では前立腺を触知できなかった.染色体検査では46,XYと正常男性型,経直腸的超音波断層法(TRUS)で測定した前立腺容積は3.6mlと著しく萎縮し,頭部MRIでは下垂体に異常を認めなかった.一方,血清テストステロンとLHは異常低値,FSHは正常下限で,またhCG負荷でテストステロンは正常値に上昇し,アリナミンテストでは嗅覚に異常を認めなかった.これらより低ゴナドトロピン型性腺機能低下症と診断し,治療としてhCG/hMGによる補充療法を開始した結果,3ヵ月後には陰毛・ヒゲ,第2次性徴の出現とテストステロン,精子数にも改善を認めた.更に4ヵ月後には前立腺容積が8.8mlと増大したが,1年2ヵ月間来院がなく7.8mlまで減少,治療再開で20mlまで増大し,その後,結婚して第1子が誕生した
A 23-year-old man visited our hospital, complaining of a lack of secondary sexual characteristics. Based on both clinical and endocrinological examinations, he was diagnosed as suffering from idiopathic hypogonadotropic hypogonadism (IHH). With human chorionic gonadotropin (hCG)/human menopausal gonadotropin (hMG) replacement therapy, clinical symptoms and serum testosterone levels improved to normal ranges. Interestingly, prostate volume as measured by transrectal ultrasonography increased considerably from 3.6 ml before treatment to 20.2 ml after treatment. The monitoring of prostate volume might be a parameter useful for evaluating the treatment effect of hCG/hMG replacement therapy in IHH.
PubMed ID: 15334897
Appears in Collections:Vol.50 No.7

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