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Komplexe endokrine Störungen

  • A. Grauer
  • W. Höppner
  • A. Lorenz
  • T. Schilling

Zusammenfassung

Eine 23-jährige Patientin mit Typ-1-Diabetesmellitus, der seit dem dritten Lebensjahr bekannt und bisher zufrieden stellend therapiert wurde, stellte sich mit entgleister Stoffwechsellage erstmalig in der Klinik vor. Die Entgleisung wurde zunächst auf Diätfehler im Rahmen der seit kurzem bestehenden Anorexia nervosa zurückgeführt. Die Patientin konnte nach adäquater Therapie in stabilem Zustand nach Hause entlassen werden. In den folgenden Wochen kam es jedoch wiederholt zu stationären Aufnahmen wegen Elektrolyt- und Blutzuckerentgleisungen. Die Patientin klagte im Wesentlichen über Müdigkeit und Abgeschlagenheit sowie trockene Haut. Bei der klinischen Untersuchung fiel eine bräunliche Verfärbung der Handlinien auf.

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Literatur

Literatur zu Abschn. 9.7

  1. Ahonen P., Miettinen A., Perheentupa J. (1987) Adrenal and steroidal cell antibodies in patients with auto immune polyglandular disease type land risk of adrenocortical and ovarian failure. J Clin Endocrinol Metab 64: 494–500PubMedCrossRefGoogle Scholar
  2. Ahonen P., Myllarniemi S., Sipila I., et al. (1990) Clinical variation of autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECD) in aseries of 68 patients. N Engl J Med 322: 1829–1836PubMedCrossRefGoogle Scholar
  3. Badenhoop K., Walfish P.G., Rau H. et al. (1995) Susceptibility and resistance alleles of human leucocyte antigen (HLA) DQA1 and HLA DQB1 are shared in endocrine auto immune disease. J Clin Endocrinol Metab 80: 2112–2117PubMedCrossRefGoogle Scholar
  4. Betterle C., Caretto A., DeZio A. et al. (1985) Incidence and significance of organ-specific auto immune disorders (clinical, latent or only autoantibodies) in patients with vitiligo. Dermatologica 171: 419–423PubMedCrossRefGoogle Scholar
  5. Björses P., Aaltonen J., Vikman A. et al. (1996) Genetic homogeneity of autoimmune polyglandular disease type I. Am J Hum Gen 59: 879–886Google Scholar
  6. Butler M.G., Hodes M.E., Conneally P.M., Biegel A.A., Wright J.C. (1984) Linkage analysis in an large kindred with autosomal-dominant transmission of polyglandular autoimmune disease type II. Am J Med Gen 18: 61–65CrossRefGoogle Scholar
  7. Chen S., Sawicka J., Betterle C. et al. (1996) Autoantibodies to steroidogenic enzymes in auto immune polyglandular syndrome, addison’s disease and premature ovarian failure. J Clin Endocrinol Metab 81: 1871–1876PubMedCrossRefGoogle Scholar
  8. Claude H. (1908) Insuffisance pluriglandulaire endocrinienne. J Physiol Pathol Gen 10: 469–480Google Scholar
  9. Csaszar T., Patakfalvi A. (1992) Treatment of polyglandular autoimmune syndrome with cyclosporin A. Acta Med Hung 49: 187–193PubMedGoogle Scholar
  10. De Bellis A., Bizzarro A., Rossi R., Paglionico V.A., Criscuolo T., Lombardi G., Bellastella A. (1993) Remission of subclinical adrenocortical failure in subjects with adrenal auto antibodies. J Clin Endocrinol Metab 76: 1002–1007PubMedCrossRefGoogle Scholar
  11. Drexhage H.A., Wulffraat N.M. (1994) Endocrine auto immune diseases. Neth J Med 45: 285–293PubMedGoogle Scholar
  12. Eisenbarth G.S. (1986) Typ 1 diabetes mellitus: chronic autoimmune disease. N Engl J Med 314: 1360–1368PubMedCrossRefGoogle Scholar
  13. Hashizume K., Ichikawa K., Nishii Y. et al. (1992) Effect of administration of thyroxine on the risk of postpartum recurrence of hyperthyroid Graves’ disease. J Clin Endocrinol Metab 75: 6–10PubMedCrossRefGoogle Scholar
  14. Herrod H.G. (1990) Chronic mucocutaneous candidiasis in childhood and complications of non-candida infection: areport of the pediatric immunodefiency Collaborative Study Group. J Pediatr 116: 377–382PubMedCrossRefGoogle Scholar
  15. Kahaly G., Förster G., Otto E., Hansen C., Schulz G. (1997) Typ 1 Diabetes mellitus als Teil des polyglandulären Autoimmunsyndroms. Diab Stoffw 6: 19–27Google Scholar
  16. Leshin M. (1985) Polyglandular auto immune syndromes. Am J Med Sci 290(2): 77–88PubMedCrossRefGoogle Scholar
  17. Mandroup-Poulsen T., Nerup J., Reimers J.I. et al. (1996) Cytokines and the endocrine System. II roles in substrate metabolism, modulation of thyroidal and pancreatic endocrine cell functions and auto immune endocrine diseases. Eur J Endocrinol 134: 21–30CrossRefGoogle Scholar
  18. Nagamine K., Kudoh J., Minoshima S., Kawasaki K., Asakawa S., Ho F., Shimizu N. (1996) Isolation of cDNA for a novel human protein KNP-I that is homologous to the E. coli SCRP-27 A protein from the auto immune polyglandular diease type I (APECED) region of chromosome 21q22.3. Biochem Biophys Res Comm 225: 606–618CrossRefGoogle Scholar
  19. Neufeld M., MaclAren N., Blizzard R.M. (1980) Autoimmune polyglandular syndromes. Pediatr Ann 4: 125–136Google Scholar
  20. Neufeld M., Maclaren N., Blizzard R.M. (1981) Two types of autoimmune Addison’s disease associated with different polyglandular auto immune (PGA) syndromes. Medicine 60: 355–362PubMedCrossRefGoogle Scholar
  21. Pfützner A., Forst T., Schilling B., Saur G., Beyer J., Kahaly G. (1996) Prävalenz von GAD 65 Auto-antikörpern bei Patienten mit autoimmunogenen Schilddrüsenerkrankungen. Diab Stoffw 5: 132–133Google Scholar
  22. Pozzilli P., Carotenuto P., Delitala G. (1994) Lymphocytic traffk and homing into target tissue and the generation of endocrine autotimmunity. Clin Endocrinol 41: 545–554CrossRefGoogle Scholar
  23. Riley W.J. (1992) Autoimmune polyglandular syndromes. Horm Res 38 (suppl. 2):9–15PubMedCrossRefGoogle Scholar
  24. Rongen-Westerlaken C., Drop S.L.S., Van Den Anker J.N. (1986) Primary adrenocortical insufficiency in chlddhood. Acta Endocrinol 279 (Suppl.):279–283Google Scholar
  25. Rose N.R. (1989) Pathogenic mechanism in auto immune disease. Clin Imunol Immunopathol 53: 7–16CrossRefGoogle Scholar
  26. Schloot N., Eisenbarth G.S. (1995) Isohormonal therapy of endocrine autoimmunity. Immunol Today 16: 289–294PubMedCrossRefGoogle Scholar
  27. Schmidt M.B. (1926) Eine biglanduläre Erkrankung (Nebenniere und Schilddrüse). Verh Dtsch Ges Path 21: 212Google Scholar
  28. Scordis N., Maclaren N. (1988) Immunogenetics of autoimmune polyglandular syndromes. In: N. R. Farid (ed) Immunogenetic of endocrine disorders. Liss, New York, pp 373Google Scholar
  29. Uibo R., Harik E., Peterson P., Perheentupa J., Aranko S., Pelkonen R., Krohn K.J.E. (1994) Autoantibodies to cytochrome P450 enzymes, P450 scc, P450 c17 and P450 c21 in autoimmune polyglandular disease types land II and in isolated Addison’s disease. J Clin Endocrinol Metab 78: 323–328PubMedCrossRefGoogle Scholar
  30. Wagner R., Genovese S., Bosi E. et al. (1994) Slow metabolic deterioration towards diabetes in islet cell antibody positive patients with auto immune polyendocrine disease. Diabetologica 37: 365–371CrossRefGoogle Scholar
  31. Whitaker J., Landing B.H., Esselborn V.M., Williams R.R. (1956) The syndrome of Juvenile hypoadrenocorticism, hypoparathyroidism and superficial moniliasis. J Clin Endocrinol Metab 16: 1374–1387PubMedCrossRefGoogle Scholar
  32. Yangxin L., Song Y-H., Rais N., Connor E., Schatz D., Muir A., MacLaren N. (1996) Autoantibodies to the etracellular domain of the calcium sensing receptor in patients with acquired hypoparathyroidismus. J Clin Invest 97: 910–914CrossRefGoogle Scholar

Literatur zu Abschn. 9.2

  1. Agarwal S.K., Kester M.B., Debelenko L.V. et al. (1997) Germline mutations of the MEN 1 gene in familial multiple endocrine neoplasia type 1 and related states. Hum Mol Genet 6: 1169–1175PubMedCrossRefGoogle Scholar
  2. Bertherat J., Turpin G., Rauch C., Li J.Y., Epelbaum J., Sassolas G., Schaison G. (1994) Presence of somatostatin receptors negatively coupled to adenylate cyclase in ectopic growth hormone-releasing hormone-and a-subunit-secreting tumors from acromegalic patients responsive to octreotide. J Clin Endocrinol Metab 79: 1457–1464PubMedCrossRefGoogle Scholar
  3. Brandi M.L., Aurbach G.D., Fitzpatrick L.A. et al. (1986) Parathyroid mitogenic activity in plasma from patients with familial multiple endocrine neoplasia type 1. N Engl J Med 314: 1287PubMedCrossRefGoogle Scholar
  4. Chandrasekharappa S.C., Guru S.C., Manickam P. et al. (1997) Positional cloning of the gene for multiple endocrine neoplasia-type 1. Science 276: 404–407PubMedCrossRefGoogle Scholar
  5. Demeure M.J., Klonoff D.C., Karam J.H., Duh Q.Y., Clark O.H. (1991) Insulinomas associated with multiple endocrine neoplasia type I: The need for a different surgical approach. Surgery 110: 998–1005PubMedGoogle Scholar
  6. Dobnig H., Steppan V., Leb G., Wolf G., Buchfelder M., Krejs G.J. (1996) Recovery from severe osteoporosis following cure from ectopic ACTH syndrome caused by an appendix carcinoid. J Intern Med 239: 365–369PubMedCrossRefGoogle Scholar
  7. Doppman J.L., Chang R., Fraker D.L. et al. (1995) Localization of insulinomas to regions of the pancreas by intra-arterial stimulation with calcium. Ann. Intern Med 123: 269–273PubMedCrossRefGoogle Scholar
  8. Friedman E., Sakaguchi K., Bale A.E. et al. (1989) Clonality of parathyroid tumors in familial multiple endocrine neoplasia type 1. N Engl J Med. 321: 213–218PubMedCrossRefGoogle Scholar
  9. Jensen R.T., Fraker D.L. (1994) Zollinger-Ellison syndrome. JAMA 271: 1429–1435PubMedCrossRefGoogle Scholar
  10. Knudson A.G. (1971) Mutation and cancer. Proc Natl Acad Sci USA 68: 820–823PubMedCrossRefGoogle Scholar
  11. Larsson C., Calender A., Grimmond S., Giraud S., Hayward N.K., Teh B., Farnebo F. (1995) Molecular tools for pesymptomatic testing in multiple endocrine neoplasia type 1. J Intern Med 238: 239–244PubMedCrossRefGoogle Scholar
  12. Lehy T., Cadiot G., Ruszniewski P., Bonfils S. (1992) Influence of multiple endocrine neoplasia type 1 on gastric endocrine cells in patients with Zollinger-Ellison-syndrome. Gut 33: 1275–1279PubMedCrossRefGoogle Scholar
  13. Lemmens I., Van-de V.W., Kas K. et al. (1997) Identification of the multiple endocrine neoplasia type 1 (MEN1) gene. The European Consortium on MENI. Hum Mol Genet 6: 1177–1183CrossRefGoogle Scholar
  14. MacFarlane M.P., Fraker D.L., Alexander H.R., Norton J.A., Lubensky I., Jensen R.T. (1995) Prospektive study of surgical resection of duodenal and pancreatic gastrinomas in multiple endocrine neoplasia type 1. Surgery 118: 973–980PubMedCrossRefGoogle Scholar
  15. Mignon M., Ruszniewski P., Podevin P., Sabbagh L., Cadiot G., Rigaud O., Bonfils S. (1993) Current approach to the management of gastrinoma and insulinoma in adults with multiple endocrine neoplasia type I. World J Surg 17: 489–497PubMedCrossRefGoogle Scholar
  16. Schröder S., Padberg B., Capella C., Frilling A., Klöppel G., Heitz P.U. (1994) Multiple endokrine Neoplasie Typ 1 (MEN 1). Pathologe. 15: 150–157PubMedCrossRefGoogle Scholar
  17. Skogseid B., Oberg K., Benson L. et al. (1987) A standardized meal stimulation test of the endocrine pancreas for early detection of pancreatic endocrine tumors in multiple endocrine neoplasia type 1 syndrome: five years experience. J Clin Endocrinol Metab 64: 1233–1240PubMedCrossRefGoogle Scholar
  18. Skogseid S., Rastad J., Gobl A. et al. (1995) Adrenal lesion in multiple endocrine neoplasia type 1. Surgery 118: 1077–1082PubMedCrossRefGoogle Scholar
  19. Takayamy T., Kameya T., Inagaki K. et al. (1993) MEN type I associated with mediastinal carcinoid producing parathyroid hormone, calcitonin and chorionic gonadotropin. Pathol Res Pract 189: 1090–1096CrossRefGoogle Scholar
  20. Thakker R.V. (1994) The role of molecular genetics in screening for multiple endocrine neoplasia type 1. Endocrinol Metab Clin North Am 23: 117–135PubMedGoogle Scholar
  21. Thompson N.W. (1992) Surgical treatment of the endocrine pancreas and Zollinger-Ellison syndrome in the MEN 1 syndrome. Henry Ford Hosp Med J 40: 195–198PubMedGoogle Scholar
  22. Thompson N.W. (1995) The surgical management of hyperparathyroidism and endocrine disease of the pancreas in themultiple endocrine neoplasia type 1 patient. J Intern Med 238: 269–280PubMedCrossRefGoogle Scholar
  23. Trump D., Farren B., Wooding C. et al. (1996) Clinical studies of multiple endocrine neoplasia type 1 (MEN1). Q J Med 89: 653–669CrossRefGoogle Scholar
  24. Underdahl L.O., Woolner L.B., Black B.M. (1953) Multiple endocrine adenomas. Report of eight cases in which parathyroids, pituitary and pancreatic islets were involved. J Clin Endocr 13: 20–27PubMedCrossRefGoogle Scholar
  25. Weinel R.J., Kisker O., Joseph K., Welcke U., Zaraca F., Rothmund M. (1994) Die Somatostatinrezeptor-Szintigraphie in der präoperativen Lokalisationsdiagnostik endokriner gastrointestinaler Tumoren. Chirurg 65: 849–855PubMedGoogle Scholar
  26. Weinel R.J., Neuhaus C., Klotter H.J., Trautmann M.E., Arnold R., Rothmund M. (1993) Standardisiertes chirurgisches Konzept zur Diagnostik und Therapie des Zollinger-EllisonSyndroms. Dtsch Med Wochenschr 118: 485–492PubMedCrossRefGoogle Scholar
  27. Wermer P. (1954) Genetic aspects of adenomatosis of endocrine glands. Amer J Med 16: 363–371PubMedCrossRefGoogle Scholar

Literatur zu Abschn. 9.3

  1. Abdelmoumene N., Schlumberger M., Gardet P., Roche A., Travagli J.P., Francese C., Parmentier C. (1994) Selective venous sampling catheterisation for localisation of persisting medullary thyroid carcinoma. Br J Cancer 69: 1141–1144PubMedCrossRefGoogle Scholar
  2. Behr T.M., Wulst E., Radetzky S. et al. (1997) Improved treatment of medullary thyroid cancer in a nude mouse model by combined radioimmunochemotherapy. Doxorubicin potentlates the therapeutic efficacy of radiolabelled antibodies in a radioresistrant tumor type. Cancer Res 57: 5309–5319PubMedGoogle Scholar
  3. Berndt I., Reuter M., Saller B. et al. (1998) A new hot spot for mutatIOns m the ret Protooncogene causing familial medullary thyroid carcinoma and multiple endocrine neoplasia type 2A. J Clin Endocrinol Metab 83: 770–774PubMedCrossRefGoogle Scholar
  4. Bonnin F., Schlumberger M., Gardet P. et al. (1994) Screening for adrenal medullary disease in patients with medullary thyroid carcinoma. J Endocrinol Invest 17: 253–257PubMedGoogle Scholar
  5. Bravo E.L. (1994) Evolving concepts in the pathophysiology, diagnosis, and treatment of pheochromocytoma. Endocr Rev 15(3):356–368PubMedGoogle Scholar
  6. Buhr H.J., Kallinowski F., Raue F., Frank-Raue K., Herfarth C. (1993) Microsurgical neck dissection for occultly metastasizing medullary thyroid carcinoma. Three-year results. Cancer 72: 3685–3693PubMedCrossRefGoogle Scholar
  7. Donis Keller H., Dou S., Chi D. et al. (1993) Mutations in the RET proto-oncogene are associated with MEN 2A and FMTC. Hum Mol Genet 2: 851–856PubMedCrossRefGoogle Scholar
  8. Eng C., Clayton D., Schuffenecker I. et al. (1996) The relationship between specific RET proto-oncogene mutations and disease phenotype in multiple endocrine neoplasia type 2. International RET mutation consortium analysis. JAMA 276: 1575–1579PubMedCrossRefGoogle Scholar
  9. Evans D.B., Lee J.E., Merrell R.C., Hickey R.C. (1994) Adrenal medullary disease in multiple endocrine neoplasia type 2: appropriate mangement. Endocrin Metab Clin N Am 23: 167–176Google Scholar
  10. Frank-Raue K., Hoppner W., Frilling A. et al. (1996) Mutations of the ret protooncogene in German multiple endocrine neoplasia families: relation between genotype and phenotype. German Medullary Thyroid Carcinoma Study Group. J Clin Endocrinol Metab 81: 1780–1783PubMedCrossRefGoogle Scholar
  11. Frank-Raue K., Kratt T., Höppner W., Buhr H., Ziegler R., Raue F. (1996) Diagnosis and management of phhenochromocytomas in patients with multiple endocrine neoplasia type 2-relevance of specific mutations in the RET proto-oncogene. Eur J Endocrinol 135: 222–225PubMedCrossRefGoogle Scholar
  12. Frank-Raue K., Raue F., Buhr H.J., Baldauf G., Lorenz D., Ziegler R. (1992) Localization of occult persisting medullary thyroid carcimoma before microsurgical reoperation: high sensitivlty of selectIve venous catheterization. Thyroid 2:113–117PubMedCrossRefGoogle Scholar
  13. Frank-Raue K., Ziegler R., Raue F. (1993) The use of octreotide in the treatment of medullary thyroid carcinoma. Horm Metab Res 27: 44–47Google Scholar
  14. Gagel R.F., Levy M.L., Donovan D.T., Alford B.R., Wheeler T., Tschen J.A. (1989) Multiple endocrine neoplasia type 2a associated with cutaneous lichen amyloidosis. Ann Intern Med 111: 802–806PubMedCrossRefGoogle Scholar
  15. Gagel R.F., Tashjian A.H. Jr., Cummings T. et al. (1988) The clinical outcome of prospective screening for multiple endocrine neoplasla type 2a. An 18-year experience. N Engl J Med 318: 478–484PubMedCrossRefGoogle Scholar
  16. Gimm O, Dralle H. (1997) Reoperation in metastasizing medullary thyroid carcmoma: Is a tumor stage-oriented approach justified. Surgery 122: 1124–1131PubMedCrossRefGoogle Scholar
  17. Grauer A., Raue F. (1997) Diagnostic value of the peptides of calcitonin gene. In: Schmldt-Gayk H., Blind E., Roth H.J. (eds) Calcium regulating hormones and markers of bone metabolism; measurement and interpretation. Clin Lab Publik, Heidelberg, pp 85–93Google Scholar
  18. Grauer A., Raue F., Gagel R.F. (1990) Changing concepts in the management of hereditary and sporadic medullary thyroid carcmoma. Endocrinol Metab Clin North Am 19: 613–635PubMedGoogle Scholar
  19. Hofstra R.M., Landsvater R.M., Ceccherini I. et al. (1994) A mutation in the RET proto-oncogene associated with multiple endocnne neoplasla type 2B and sporadic medullary thyroid carcinoma. Nature 367: 375–376.PubMedCrossRefGoogle Scholar
  20. Hofstra R.M., Sijmons R.H., Stelwagen T. et al. (1996) RET mutation screening in familial cutaneous lichen amyloidosis and in skin amyloidosis associated with multiple endocrine neoplasia. J Invest Dermatol 107: 215–218PubMedCrossRefGoogle Scholar
  21. Ito S., Iwashita T., Asai N., Mukarami H., et al. (1997) Biological properties of RET with cysteine mutations correlate with multiple endocrine neoplasia type 2A, familial medullary thyrold carcmoma, and Hirschsprung’s disease phenotype. Cancer Res 57: 2870–2872PubMedGoogle Scholar
  22. Juweid M., Sharkey R.M., Swayne L.C., Goldenberg D.M. (1997) Improved selection of patients for reoperation for medullary thyroid cancer by imaging with radiolabeled antiearcinoembryonic antigen antibodies. Surgery 122: 1156–1165PubMedCrossRefGoogle Scholar
  23. Komminoth P. (1997) The RET proto-oncogene in medullary and papillary thyroid carcinoma. Molecular features, pathophysiology and clincal implications. Virchows Arch 431: 1–9PubMedCrossRefGoogle Scholar
  24. Lee J.E., Curley S.A., Gagel R.F., Evans D.B., Hickey R.C. (1996) Cortical-sparing adrenalectomy for patients with bilateral pheochromocytoma. Surgery 120: 1064–70PubMedCrossRefGoogle Scholar
  25. Lupoli G., Cascone E., Arlotta F., Vitale G., Celentano L., Salvatore M., Lombardi G. (1996) Treatment of advanced medullary thyroid carcinoma with a combination of recombinant interferon u-2b and octreotide. Cancer 78: 1114–1148PubMedCrossRefGoogle Scholar
  26. Modigliani E., Vasen H.M., Raue K. et al. (1995) Pheochromocytoma in multiple endocnne neoplasia type 2: European study. J Intern Med 238: 363–367PubMedCrossRefGoogle Scholar
  27. Moers A.M., Landsvater R.M., Schaap C. et al. (1996) Familial medullary thyroid carcinoma: not a distinct entity? Genotype-phenotype correlation in a large family. Am J Med 101: 635–641PubMedCrossRefGoogle Scholar
  28. Mulligan L.M., Eng C., Healey C.S. et al. (1994) Specific mutations of the RET proto-oncogene are related to disease phenotype in MEN 2A and FMTC. Nature Genet 6: 70–74PubMedCrossRefGoogle Scholar
  29. Mulligan L.M., Kwok J.B., Healey C.S. et al. (1993) Germ-line mutations of the RET proto-oncogene in multiple endocrine neoplasia type 2A. Nature 363: 458–460PubMedCrossRefGoogle Scholar
  30. Ponder B.A., Ponder M.A., Coffey R., Pembrey M.E., Gagel R.F., Telenius-Berg M., Semple P., Easton D.F. (1988) Risk estimation and screening in families of patients with medullary thyroid carcinoma. Lancet 1: 397–401PubMedCrossRefGoogle Scholar
  31. Raue F., Frank Raue K., Grauer A. (1994) Multiple endocrine neoplasia type 2. Clinical features and screening. Endocrinol Metab Clin North Am 23: 137–156PubMedGoogle Scholar
  32. Raue F., Geiger S., Buhr H., Frank-Raue K., Ziegler R. (1993) Prognostische Bedeutung des Kalzitonin-Screenings beim familiären medullären Schilddrüsenkarzinom. Dtsch Med Wochenschr 118: 49–52PubMedCrossRefGoogle Scholar
  33. Raue F., Kraimps J.L., Dralle H. et al. (1995) Primary hyperparathyroidism in multiple endocrme neoplasia type 2A. J Intern Med 238: 369–373PubMedCrossRefGoogle Scholar
  34. Saad M.F., Ordonez N.G., Rashid R.K., Guido J.J., Hili C.S., Jr., Hikkey R.C., Samaan N.A. (1984) Medullary carcinoma of the thyroid: a study of the clinical features and prognostic factors in 161 patients. Medicine 63: 319–342PubMedCrossRefGoogle Scholar
  35. Santoro M., Carlomagno F., Romano A. et al. (1995) Activation of RET as a dominant transforming gene by germline mutations of MEN 2A and MEN 2B. Science 267: 381–383PubMedCrossRefGoogle Scholar
  36. Scherübl H., Raue F., Ziegler R. (1990) Combination chemotherapy of advanced medullary and differentiated thyroid cancer. J Cancer Res Clin Oncol 116: 21–23PubMedCrossRefGoogle Scholar
  37. Smith D.P., Houghton C., Ponder B.A. (1997) Germline mutation of RET codon 882 in two cases of de novo MEN 2b. Oncogene 15: 1213–1217PubMedCrossRefGoogle Scholar
  38. Trupp M., Arena E., Fainzilber M. et al. (1996) Functional receptor for GDNF encoded by the c-ret proto-oncogene. Nature 381: 785–789PubMedCrossRefGoogle Scholar
  39. van Heyningen V. (1994) Genetics. One gene-four syndromes. Nature 367: 319–320PubMedCrossRefGoogle Scholar
  40. Vasen H.F., van der Feltz M., Raue F. et al. (1992) The natural course of multiple endocrine neoplasia type IIb. A study of 18 cases. Arch Intern Med 152: 1250–1252PubMedCrossRefGoogle Scholar
  41. Wu L.T., Averbuch S.D., Ball D.W., de Bustros A., Baylin S.B., McGuire W.P. 3rd. (1994) Treatment of advanced medullary thyroid carcinoma with a combination of cyclophosphamide, vincristine, and dacarbazine. Cancer 73: 432–436PubMedCrossRefGoogle Scholar
  42. Zink A., Blind E., Raue F. (1992) Determination of serum calcitonin by immunometric two-site assays in normal subjects and patients with medullary thyroid carcinoma. Eur J Clin Chem Clin Biochem 30: 831–835PubMedGoogle Scholar

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© Springer-Verlag Berlin Heidelberg 2001

Authors and Affiliations

  • A. Grauer
  • W. Höppner
  • A. Lorenz
  • T. Schilling

There are no affiliations available

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