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Neuroendocrine Dysfunction in African Trypanosomiasis: The Role of Cytokines a
Author(s) -
REINCKE MARTIN,
ARLT WIEBKE,
HEPPNER CHRISTINA,
PETZKE FRANK,
CHROUSOS GEORGE P.,
ALLOLIO BRUNO
Publication year - 1998
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1111/j.1749-6632.1998.tb09619.x
Subject(s) - endocrine system , hypopituitarism , thyroid , endocrinology , thyroid function , medicine , hypophysitis , thyroiditis , infertility , african trypanosomiasis , adrenal insufficiency , hypogonadotropic hypogonadism , hormone , pituitary gland , immunology , biology , trypanosomiasis , pregnancy , genetics
A bstract : Sleeping sickness (SS; African trypanosomiasis) is an anthropozoonosis transmitted by the tsetse fly. Infection with Trypanosoma brucei in humans is associated with adynamia, lethargy, anorexia, and more specifically amenorrhea/infertility in women and loss of libido/impotence in men. Recent evidence suggests that experimental infection in animals with Trypanosoma brucei species causes polyglandular endocrine failure by local inflammation of the pituitary, thyroid, adrenal, and gonadal glands. In a cross‐sectional study we investigated the prevalence and significance of neuroendocrine abnormalities in 137 Ugandan patients with SS. In the untreated stage of the disease, there was a high prevalence of adrenal insufficiency (27%), hypothyroidism (50%) and hypogonadism (85%). Pituitary function tests suggested an unusual combined central (hypothalamic/pituitary) and peripheral defect in hormone secretion. Specific therapy resulted in a rapid recovery of adrenal/thyroid function, whereas hypogonadism persisted for years in a substantial portion of patients. We did not detect pituitary, thyroid, adrenal, and gonadal autoantibodies in patients with endocrine dysfunction, ruling out an autoimmune origin of the endocrine abnormalities. However, the presence of hypopituitarism correlated with high cytokine concentrations (TNF‐alpha, IL‐6) which‐together with direct parasitic infiltration of the endocrine glands‐are involved in the pathogenesis of SS‐associated endocrine dysfunction.