特発性腎出血のセロトニン代謝

概要

論文の詳細を見る
5-hydroxyindol acetic acid (5-HIAA), a terminal metabolite of serotonin appeared in the urine, was estimated in patients with so-called essential renal bleeding. Average excretion rate of 5-HIAA in 52 patients was 5.7 ± 1.7 mg/day which is significantly higher than that of 4.4 ± 2.1 mg/day in 20 normals (P<0.01). Oral administration of E-aminocaproic acid caused the decrease of urinary 5-HIAA excretion in 20 patients but no significant effects in normal subjects and patients with other diseases. The aforementioned results suggested the possibility of anti-serotonin therapy for this essential renal leeding. Thus the treatment with one of the serotonin antagonists "cyproheptadine" was attempted in 34 patients resulting the control of hematuria in 16 patients. Transient increase and then gradual decrease of 5-HIAA excretion in the urine were noted after cyproheptadine administration. The response of this transient increase differed between effective and ineffective cases. The former exhibited stronger response than the latter. Therefore cyproheptadine test was offered to judge the effectiveness of anti-serotonin therapy. From the results obtained in this study the conclusion was withdrawn that serotonin might play an important role in the pathogenesis of essential renal bleeding.
社団法人日本泌尿器科学会の論文