Endocrine journal最新文献

{"title":"Utility of gel filtration chromatography in evaluating successful resection of ectopic adrenocorticotropic hormone-producing tumor: a case report and literature review.","authors":"Mei Nakatsuji, Hironori Bando, Masaaki Yamamoto, Maki Kanzawa, Takefumi Doi, Yasutaka Tsujimoto, Kei Yoshino, Hidenori Fukuoka, Itsuko Sato, Yoshihiko Yano, Yugo Tanaka, Wataru Ogawa","doi":"10.1507/endocrj.EJ25-0098","DOIUrl":"https://doi.org/10.1507/endocrj.EJ25-0098","url":null,"abstract":"<p><p>Ectopic adrenocorticotropic hormone (ACTH) syndrome resulting from ectopically secreting tumors poses a significant clinical challenge. Accurately identifying the tumor source and achieving curative resection are pivotal for patient prognosis; however, achieving these objectives is often complicated by complex ACTH secretion patterns. High-molecular-weight ACTH, frequently secreted by ectopic ACTH-producing tumors, is distinct from the conventional 39-amino-acid ACTH (ACTH_1-39) produced by the pituitary gland. We believe that the evaluation of ACTH characteristics using gel filtration chromatography (GFC) can be used to determine whether curative resection can be achieved. A patient with ectopic ACTH syndrome owing to a thymic neuroendocrine tumor was enrolled in this study. Despite a marked reduction in plasma ACTH levels post-surgery, the levels remained above the detection threshold, raising concerns regarding potential residual tumor activity. To investigate this further, GFC was employed to differentiate between ACTH_1-39 and high-molecular-weight ACTH in postoperative plasma samples. High-molecular-weight ACTH was predominant in the postoperative samples, whereas preoperative peripheral blood was primarily composed of ACTH_1-39. These findings suggest that sustained low-level ACTH post-surgery was likely owing to a delayed clearance of high-molecular-weight ACTH rather than a residual tumor activity. This interpretation is supported by the patient's favorable postoperative course and long-term follow-up, which showed no recurrence. This case study highlights the novel potential of GFC for aiding clinical decision-making.</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurological consequences of adult-onset hypothyroidism.","authors":"Izuki Amano, Ayane Ninomiya, Noriyuki Koibuchi","doi":"10.1507/endocrj.EJ25-0163","DOIUrl":"https://doi.org/10.1507/endocrj.EJ25-0163","url":null,"abstract":"<p><p>Adult-onset hypothyroidism has long been recognized as a reversible cause of cognitive impairment. However, recent studies have shown that it is associated with structural brain alterations besides functional alterations, particularly in the hippocampus and prefrontal cortex. Neurophysiological and molecular studies have demonstrated that hypothyroidism impairs synaptic plasticity, disrupts neurotransmitter signaling, and promotes neuroinflammation, leading to learning and memory impairments. The condition also affects adult neurogenesis, particularly in the hippocampal dentate gyrus. Moreover, hypothyroidism has been linked to psychiatric disorders, including depression and anxiety, through its influence on the plasticity of the amygdala. In addition, adult-onset hypothyroidism contributes to cerebellar ataxia and peripheral neuropathy, impacting motor coordination and sensory processing. Since we come to know that adult-onset hypothyroidism in part causes irreversible changes in brain structure, prompt treatment is crucial. Furthermore, in addition to thyroid field, recent studies suggest a potential of thyroid hormone treatment beyond the thyroid disorders, such as neurodegenerative and cognitive/psychiatric disorders. This review highlights the critical role of THs in maintaining neural function and explores their therapeutic potential in addressing neurological and psychiatric conditions.</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Goiter index: an easily available ultrasonographic index for thyroid volume in autoimmune thyroid diseases.","authors":"Tsukasa Murakami, Naoyuki Higaki, Yui Nishijima, Junichi Tani, Hitoshi Noguchi, Misako Eto","doi":"10.1507/endocrj.EJ25-0070","DOIUrl":"https://doi.org/10.1507/endocrj.EJ25-0070","url":null,"abstract":"<p><p>This study aimed to confirm the applicability of the product of depth and width of the right thyroid lobe measured by ultrasonography, as an index of estimated thyroid volume in patients with Hashimoto thyroiditis. This study included 118 patients with Hashimoto thyroiditis and 163 patients with Graves' disease. The product of depth and width of the right thyroid lobe ranged from 1.7 to 10.2 (median, 4.4) cm² for Hashimoto thyroiditis and 2.6 to 10.8 (median, 5.8) cm² for Graves' disease. The estimated volume obtained by ellipsoidal approximation correlated well with the product of depth and width of the right thyroid lobe in Hashimoto thyroiditis (ρ = 0.820, p < 0.0001) and Graves' disease (ρ = 0.928, p < 0.0001), respectively. However, the correlations were not identical. The comparison of 72 patients with Hashimoto thyroiditis and 72 patients with Graves' disease who were matched for the product of depth and width revealed no significant difference in the estimated thyroid volume. These results show that the product of depth and width of the right thyroid lobe can be applied to indicate thyroid volume instead of the estimated volume obtained from ellipsoidal approximation in both Hashimoto thyroiditis and Graves' disease within the range of volumes investigated in this study.</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single bolus injection of nicotinamide mono nucleotide increases systemic insulin sensitivity in association with activation of NAD salvage pathway in the liver and adipose tissue in mice.","authors":"Shunsuke Hiroshige, Yasuko Kajimura, Yuko Nagao, Akihiko Taguchi, Ryoko Hatanaka, Chika Yodokawa, Yuka Fujioka, Masaru Akiyama, Yukio Tanizawa, Yasuharu Ohta","doi":"10.1507/endocrj.EJ24-0312","DOIUrl":"https://doi.org/10.1507/endocrj.EJ24-0312","url":null,"abstract":"<p><p>Rising nicotinamide adenine dinucleotide (NAD⁺) levels mitigate the onset and progression of age-related diseases including metabolic disorders. Several studies have demonstrated that NAD⁺ levels can be efficiently replenished via nicotinamide mononucleotide (NMN) intake and thereby prevent metabolic disorders. However, the acute effects of NMN administration on metabolism remain unclear. We observed metabolic dynamics after a single bolus injection of NMN. Sirt1 and Nampt mRNA levels were increased in the liver suggesting that intracellular NAD⁺ increased after injection. During OGTT, glucose tolerance and insulin secretion did not change significantly in response to NMN administration, while during ITT, increased insulin sensitivity was observed in muscle. NMN administration decreased serum non-esterified free fatty acid (NEFA) concentrations, which would presumably be responsible for the increased muscle insulin sensitivity. Furthermore, NMN administration reduced the respiratory quotient, confirming that NMN promotes utilization of lipids as an energy source. Our data demonstrate acute effects of NMN on metabolism and raise the possibility of NMN as a treatment for metabolic disorders.</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ectopic production of 1,25-dihydroxyvitamin D in high-grade intranasal non-intestinal-type adenocarcinoma induced hypercalcemic crisis: a case report with review of literature.","authors":"Muneo Kawasumi, Mitsunobu Kubota, Hiromi Furuie, Kazuya Kuraoka","doi":"10.1507/endocrj.EJ25-0038","DOIUrl":"https://doi.org/10.1507/endocrj.EJ25-0038","url":null,"abstract":"<p><p>Hypercalcemia is an oncologic metabolic emergency in cancer patients, primarily caused by local osteolytic hypercalcemia and humoral hypercalcemia of malignancy. Hormones associated with oncologic metabolic emergency include parathyroid hormone and parathyroid hormone-related peptide (PTHrP), but 1,25-dihydroxyvitamin D (1,25(OH)₂D) is rarely the cause. We report the case of an 87-year-old man with hypercalcemic crisis owing to 1,25(OH)₂D overproduction from a high-grade intranasal non-intestinal-type adenocarcinoma. 1,25(OH)₂D and corrected Ca levels normalized after tumor resection and did not re-elevate subsequently. Serum PTH was suppressed and PTHrP not detected, suggesting the hypercalcemia was not due to the PTH pathway. Immunohistochemistry for CYP27B1, a key enzyme that converts 25-hydroxyvitamin D (25(OH)D) to 1,25(OH)₂D, showed positivity in the cytosol of about 20% of tumor cells, but only about 1% of the macrophages. On the other hand, CYP24A1, a 1,25(OH)₂D-degrading enzyme, was diffusely expressed in the cytosol of about 80% of tumor cells. These findings may suggest overproduction of CYP27B1 mRNA. The balance between synthesis and degradation of 1,25(OH)₂D in tumor tissue is thought to be implicated in the development of 1,25(OH)₂D-producing solid tumors. Further case accumulation and studies will be needed to confirm this hypothesis. Nonetheless, in diagnosing 1,25(OH)₂D-producing solid tumors, it is important to evaluate not only CYP27B1 expression but also CYP24A1.</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The influence of hypertensive disorders of pregnancy on the development of long-term postpartum type 2 diabetes mellitus.","authors":"Shota Inoue, Yasunori Takata, Yasuharu Tabara, Koutatsu Maruyama, Ayaka Yoshida, Haruhiko Osawa, Takashi Sugiyama","doi":"10.1507/endocrj.EJ25-0033","DOIUrl":"10.1507/endocrj.EJ25-0033","url":null,"abstract":"<p><p>The association between hypertensive disorders of pregnancy (HDP) and the subsequent development of type 2 diabetes (T2D) in Japanese general population remains unclear. To investigate the influence of HDP on long-term postpartum development of metabolic disorders and T2D, we conducted a population-based cross-sectional study using the 75 g oral glucose tolerance test (75g-OGTT) in 978 parous Japanese women (median age: 66 years). We further evaluated the combined effect of HDP and T2D susceptibility genes on developing T2D. HDP history was identified in 101 participants (10.3%) and associated with high blood pressure, hypertriglyceridemia, increased homeostasis model assessment 2 for insulin resistance, decreased Matsuda index and insulin secretion-sensitivity index-2, increased postprandial glucose levels during the 75g-OGTT, and increased prevalence of hypertension, metabolic syndrome and T2D. The age and BMI adjusted odds ratio (OR) for T2D was 1.74 (95%CI: 1.04-2.93) in individuals with HDP as compared to those without HDP. Stratified analyses demonstrated an increased OR of T2D prevalence for individuals with HDP history harboring the cyclin-dependent kinase 5 regulatory subunit associated protein 1-like 1 (CDKAL1) C/C genotype compared with that of the reference group after adjusting for age and current BMI (OR = 5.18 vs. reference group; 95% CI: 1.99-13.50). Further, validation analyses using bootstrap method showed high reproducibility. HDP history was associated with postpartum prevalence of hypertension, insulin resistance and T2D later in life in Japanese general population. Further, the simultaneous assessment of an HDP history and CDKAL1 genotype is valuable to predict the future T2D development (UMIN000036074).</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":"727-741"},"PeriodicalIF":1.3,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of therapeutic inorganic iodine on long-term prognosis of Graves' disease: a multicenter prospective observational study.","authors":"Hiroki Takizawa, Toyoyoshi Uchida, Nami Suzuki, Hiroyuki Onose, Emiko Yamada, Koshi Hashimoto, Natsuko Watanabe, Yuya Nishida, Hirotaka Watada","doi":"10.1507/endocrj.EJ24-0575","DOIUrl":"10.1507/endocrj.EJ24-0575","url":null,"abstract":"<p><p>Inorganic iodine has long been used as a treatment for Graves' disease. It is currently a treatment option for mild Graves' disease, but there have been no data suggesting the validity of continuing low-dose iodine treatment after improvement in thyrotoxicosis. For this prospective observational study, we recruited patients with Graves' disease treated only with low-dose iodine (potassium iodine ≤25 mg/day). These patients were then divided into two groups: those who continued with low-dose iodine (C group) and those who discontinued it (DC) group. We compared the 2-year thyrotoxicosis relapse rate between the two groups and investigated anthropometric variables associated with relapse. Of 2,159 patients on iodine treatment, 56 patients met the selection criteria but 4 who gave consent dropped out, leaving 25 in the C group and 27 in the DC group. Regarding baseline characteristics, the C group had a longer duration of Graves' disease, lower therapeutic iodine doses, and lower TSH levels than the DC group. During the 2-year follow-up period, the relapse rate in the C and DC groups was 32.0% and 22.2%, respectively (p = 0.536). Furthermore, patients who relapsed had significantly higher therapeutic iodine doses, FT4 levels, and TSAb levels at baseline than patients who did not relapse. Multiple logistic regression showed that relapse is positively associated with therapeutic iodine dose and TSAb levels. The present study failed to show the efficacy of continuing low-dose iodine in patients with Graves' disease after improvement in thyrotoxicosis. The relapse rate seems to be affected by residual immune activity. UMIN000047660.</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":"663-670"},"PeriodicalIF":1.3,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disseminated intravascular coagulation as a frequent and critical complication of thyroid storm: a single-center retrospective survey.","authors":"Ayako Hoshiyama, Akinori Hayashi, Tomomi Taguchi, Yasuhiro Ohata, Akihiko Suzuki, Tsuguto Masaki, Raishi Ichikawa, Yuji Kamata, Takeshi Miyatsuka","doi":"10.1507/endocrj.EJ24-0542","DOIUrl":"10.1507/endocrj.EJ24-0542","url":null,"abstract":"<p><p>Thyroid storm (TS) is a rare but fatal endocrine emergency with high mortality, and there have been few detailed reports on its severity and possible complications to date. Therefore, a single-center retrospective survey was conducted to comprehensively analyze the severity, treatments, and complications of patients with thyroid storm who were admitted to Kitasato University Hospital between 2012 and 2023. A total of 22 patients who experienced thyroid storm were extracted; 19 patients (86%) had Graves' disease, among which 12 patients were newly diagnosed, and there were 4 fatalities (18.1%) during the study period. The median Acute Physiology and Chronic Health Evaluation II (APACHE II) score and median Sequential Organ Failure Assessment (SOFA) score were 20 and 5, respectively, and both scores were higher in critical patients who needed ventilation, continuous hemodialysis and filtration, therapeutic plasma exchange, percutaneous cardiopulmonary support, extracorporeal membrane oxygenation, or who finally died. Diagnostic criteria for disseminated intravascular coagulation (DIC) were met in five patients (23%) who had significantly higher scores on the Burch-Wartofsky Point Scale as well as APACHE II and SOFA scores than the other patients. Thus, DIC is a frequent and critical complication of TS, which can lead to severe consequences, suggesting the necessity of prompt and intensive management of these patients.</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":"719-726"},"PeriodicalIF":1.3,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of the random C-peptide and random C-peptide index at diagnosis as a predictor of disease type and long-term insulin secretory capacity in children with diabetes mellitus.","authors":"Keita Numasawa, Kentaro Shiga, Makiko Kitao, Hiroaki Konno, Kuniyuki Nishiyama, Koji Ohsugi, Kanako Ebina, Nobuyuki Kikuchi, Shuichi Ito","doi":"10.1507/endocrj.EJ24-0517","DOIUrl":"10.1507/endocrj.EJ24-0517","url":null,"abstract":"<p><p>The random C-peptide and random C-peptide index (CPI) have been shown to be useful in assessing endogenous insulin secretory capacity in adults with type 2 diabetes. This study aimed to clarify the utility of C-peptide and the CPI in early classification of long-term insulin-dependent status in pediatric diabetes patients. A total of 204 patients aged ≤15 years who received an initial diagnosis of acute-onset type 1 diabetes mellitus (T1DM), slowly progressive insulin-dependent diabetes mellitus (SPIDDM), or type 2 diabetes mellitus (T2DM) at Yokohama City University Medical Center between April 1, 2003 and March 31, 2018 were included. The acute-onset T1DM, SPIDDM, and T2DM groups included 140, 8, and 56 patients, respectively. The median random C-peptide values were 0.67, 3.18, and 4.16 ng/mL and median random CPI values were 0.19, 2.02, and 2.53 for acute-onset T1DM, SPIDDM, and T2DM cases, respectively (acute-onset T1DM vs. T2DM, p < 0.001 (C-peptide), p < 0.001 (CPI), acute-onset T1DM vs. SPIDDM, p < 0.001 (C-peptide), p < 0.001 (CPI), SPIDDM vs. T2DM, p = 0.04 (C-peptide), p = 0.19 (CPI)). Receiver operating characteristic analysis cutoff values of C-peptide levels in differentiating acute-onset T1DM from SPIDDM and acute-onset T1DM from T2DM were 1.60 ng/mL (sensitivity 87.5%, specificity 90.6%) and 1.81 ng/mL (sensitivity 91.1%, specificity 93.5%), while the respective CPI values were 0.46 (100% sensitivity, 77% specificity) and 1.05 (92.1% sensitivity, 87.5% specificity). This study indicates that the random C-peptide and random CPI at diagnosis are helpful in the early classification of childhood diabetes and determining an appropriate time to introduce insulin and predicting the subsequent clinical course.</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":"697-705"},"PeriodicalIF":1.3,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pheochromocytoma associated with ectopic ACTH-producing tumor and hyper-interleukin-6emia: a case report with review of literature.","authors":"Hironori Nakahira, Shozo Miyauchi, Kyoko Watanabe, Kazuyuki Akesaka, Keizo Ono, Osamu Ebisui, Teruki Miyake, Shinya Furukawa, Yoichi Hiasa, Bunzo Matsuura","doi":"10.1507/endocrj.EJ24-0459","DOIUrl":"10.1507/endocrj.EJ24-0459","url":null,"abstract":"<p><p>Pheochromocytomas occur in the adrenal medulla and present with various symptoms associated with excessive catecholamine production. Although pheochromocytomas associated with ectopic ACTH-producing tumors and hyper-interleukin-6emia (hyper-IL-6emia) have been reported, those associated with both diseases simultaneously have not been reported. In pheochromocytomas with ectopic ACTH-producing tumors and hyper-IL-6emia, the disease characteristics and relationship between each hormone and cytokine are unknown. Herein, we report a case of a 56-year-old woman with stroke whose computed tomography scans of the abdomen revealed a right adrenal tumor on systemic examination. Endocrinological examination revealed elevated plasma levels of catecholamines and their metabolites in the urine and elevated levels of plasma ACTH, serum cortisol, and serum dehydroepiandrosterone sulfate, leading to a diagnosis of right pheochromocytoma and associated ectopic ACTH-producing tumor. Furthermore, hyper-IL-6emia was detected as a key indicator of anemia due to inflammatory hematopoietic disorders. The patient's general condition improved with drug therapy, including 1,000 mg/d of metyrapone, 2 mg/h of phentolamine, 8 mg/d of doxazosin, and systemic management. Dexamethasone suppression tests demonstrated suppressed serum cortisol and IL-6 levels, and dexamethasone dose-dependently increased plasma adrenaline and noradrenaline levels. These findings indicate that excess glucocorticoids play a stimulatory role in catecholamine secretion and a concentration-suppressive role in serum IL-6 levels in pheochromocytomas associated with ectopic ACTH-producing tumors and hyper-IL-6emia. The presence of rare comorbidities should be considered if the clinical findings cannot be explained by the pathophysiology of a pheochromocytoma alone because pheochromocytomas can be associated with the production of other hormones and cytokines.</p>","PeriodicalId":11631,"journal":{"name":"Endocrine journal","volume":" ","pages":"743-750"},"PeriodicalIF":1.3,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}