Changes in endocrine function after adrenal medullary transplantation to the central nervous system.
Ten patients were studied before and after autologous adrenal medullary transplantation to the central nervous system for Parkinson's disease to determine if the presence of new catecholamine-producing tissue near the hypothalamus would alter hypothalamic or pituitary function, mineralocorticoid levels, or catecholamine production. No clinically apparent ill effects occurred. Changes in endocrine function were largely short-term and transient: at 7-10 days after surgery, urinary catecholamine levels were significantly increased, PRL levels were significantly elevated despite markedly increased serum dopamine levels, and gonadal steroid levels (estradiol and testosterone) were significantly lower despite unchanged basal and stimulated levels of gonadotropins. Dehydroepiandrosterone sulfate was significantly reduced at 7-10 days after surgery and remained low at 3-6 months. Other changes at 3-6 months after surgery included increased stimulated corticotropin levels and reduced serum aldosterone response to upright posture. The changes at 7-10 days were probably due to stress or unilateral adrenalectomy or both; the changes at 3-6 months were likely due to unilateral adrenalectomy. We conclude that unilateral adrenalectomy and autologous adrenal medullary transplantation to the central nervous system does not produce clinically important changes in endocrine function; however, possible adverse consequences of long-term reduction of dehydroepiandrosterone sulfate levels cannot be excluded.
Department of Medicine, Emory University School of Medicine, Atlanta, Georgia 30322.
N B
NB
Watts
R V
RV
Clark
R L
RL
Watts
S D
SD
Graham
R A
RA
Bakay
D000313:Adrenal Medulla / Q000637:transplantation*; D000328:Adult; D000368:Aged; D002421:Caudate Nucleus / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007031:Hypothalamus / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000601:surgery*; D010901:Pituitary Function Tests; D010903:Pituitary Gland, Anterior / Q000502:physiology*; D014182:Transplantation, Autologous