A Case of Factitious Adrenal Insufficiency after Vascular Graft Surgery Caused by Spurious Immunometric Assays

• SAKAI Haruna

  Department of Clinical and Molecular Endocrinology, Tokyo Medical and Dental University Graduate School

• MATSUMOTO Kazue

  Department of Clinical Laboratory, Tokyo Medical and Dental University Hospital

• SUGIYAMA Miho

  Department of Clinical and Molecular Endocrinology, Tokyo Medical and Dental University Graduate School

• YOSHIMOTO Takanobu

  Department of Clinical and Molecular Endocrinology, Tokyo Medical and Dental University Graduate School

• DOI Masaru

  Department of Clinical and Molecular Endocrinology, Tokyo Medical and Dental University Graduate School

• IZUMIYAMA Hajime

  Department of Clinical and Molecular Endocrinology, Tokyo Medical and Dental University Graduate School

• HIRATA Yukio

  Department of Clinical and Molecular Endocrinology, Tokyo Medical and Dental University Graduate School

抄録

A 70-year-old man with abdominal aortic aneurysm underwent surgical repair with Hemashield vascular graft. Postoperatively, he was found to have very low plasma cortisol levels, which failed to increase after stimulation with ACTH. A tentative diagnosis of adrenal insufficiency was made despite the lack of its clinical manifestations and a replacement therapy with hydrocortisone was started. He had also elevated plasma levels of TSH, thyroid hormones and estrogen without any clinical manifestations. Such abnormal hormone levels were spontaneously normalized three months after operation, which was later proven to be factitious by different immunometric assays (IMA). Since the vascular graft coated with bovine type I collagen has been reported to induce a transient immune response in some patients after surgery, we speculated that certain antibodies generated against heterologous collagen and/or yet-unknown components derived from the graft may have caused such factitious data; exogenous addition of bovine type I collagen and albumin to patient's serum, however, failed to affect the assay results. Whatever the cause, caution must be paid that some patients with surgical repair using heterologous materials may have such factitious hormone data by IMAs.<br>

収録刊行物

• Endocrine Journal

  Endocrine Journal 53 (3), 415-419, 2006

  一般社団法人 日本内分泌学会

キーワード

• Factitious hormone data
• Immunometric assays (IMA)
• Collagen-coated vascular graft

詳細情報

• CRID: 1390282681274093824
• NII論文ID: 10018178238
• NII論文ID: 130004443239
• NII書誌ID: AA10901436
• DOI: 10.1507/endocrj.k06-006
• ISSN: 13484540
• ISSN: 09188959
• Web Site: http://www.jstage.jst.go.jp/article/endocrj/53/3/53_3_415/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2007068933
• 本文言語コード: en
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