晚期出现的施密特综合征与严重的低血量呈现:一个病例报告
Stella Pigni1,2, Giacomo Cristofolini1,2, Simona Jaafar1,2
1Department of Biomedical Sciences, Humanitas University, via Rita Levi Montalcini 4, Pieve Emanuele, 20090, Milan, Italy.
Endocrine, metabolic & immune disorders drug targets
|July 18, 2024
概括
施密特综合征是一种罕见的自身免疫性疾病,即使在晚发病的情况下,也可以表现为严重的低血量作为第一个症状. 早期怀疑和适当的治疗对于患者的治疗结果至关重要.
科学领域:
- 内分泌学 在内分泌学.
- 内部医学 内部医学
- 自体免疫学 自体免疫学
背景情况:
- 施密特综合征 (SS) 结合了自身免疫性甲状腺炎 (AIT) 和自身免疫性亚迪逊病 (aAD).
- 自免疫艾迪逊病通常是最初的表现,通常在年轻的成年女性.
- 这一案例突出了SS的罕见实例,其主要症状是晚期发病的aAD和严重的低血症.
研究的目的:
- 报告一个罕见的施密特综合征病例,与晚发性自身免疫艾迪逊病一起出现.
- 强调低血症作为aAD的潜在早期指标的重要性.
- 讨论心脏病老年患者的管理挑战和考虑.
主要方法:
- 一个73岁妇女的病例报告,有AIT和心肌病史.
- 呈现出严重的低血,混乱和低血压.
- 通过激素水平和自身抗体证实原发性上腺功能不充分的诊断;开始用皮和皮治疗.
主要成果:
- 患者出现严重的低血量 (99mEq/l) 和精神状态的改变.
- 最初用盐水和皮治疗导致临床改善和正常化.
- 过度替换矿物质皮质类药物导致过渡性心力衰竭和低血,需要调整剂量.
结论:
- 严重的低血值值得怀疑自身免疫艾迪逊病,特别是在自身免疫性甲状腺炎患者中.
- 在患有心脏病的老年患者中,精心管理葡萄糖皮质激素和花皮质治疗是必不可少的,以预防并发症.
- 这一案例强调了在诊断低血症时考虑aAD的重要性,无论患者的年龄如何.
相关概念视频
Antihypertensive Drugs: Potassium-Sparing Diuretics
504
Liddle syndrome is a genetically inherited form of hypertension characterized by the overactivity of epithelial sodium channels in the nephron, the functional unit of the kidney. This heightened activity leads to increased sodium reabsorption and excessive excretion of potassium. To counteract this, potassium-sparing diuretics such as amiloride are used. They function by blocking these sodium channels, thereby reducing the influx of sodium into the epithelial cells and minimizing the loss of...
504
Disorder of Water Balance
344
Water balance disorders are medical conditions that occur when there is a deviation from the body's water volume or osmolarity, disrupting normal homeostasis and leading todehydration, hypotonic hydration, hyperhydration, edema, or water intoxication.
Dehydration
Dehydration occurs when the body loses fluids (particularly water).
Causes:
The major causes of dehydration include excessive sweating, fever, vomiting, diarrhea, and diuresis.
Signs and Symptoms:
Symptoms primarily include intense...
Dehydration
Dehydration occurs when the body loses fluids (particularly water).
Causes:
The major causes of dehydration include excessive sweating, fever, vomiting, diarrhea, and diuresis.
Signs and Symptoms:
Symptoms primarily include intense...
344
Renal Tubule and Collecting Duct
900
The renal tubule is divided into three parts: the proximal convoluted tubule (PCT), the Loop of Henle (LOH), and the distal convoluted tubule (DCT).
Proximal Convoluted Tubule (PCT):
The PCT is the initial segment of the renal tubule, extending from the Bowman's capsule that encloses the glomerulus. Its convoluted structure and microvilli-lined cells increase the surface area for reabsorption. The PCT reabsorbs glucose, amino acids, sodium, and water from the filtrate, ensuring essential...
Proximal Convoluted Tubule (PCT):
The PCT is the initial segment of the renal tubule, extending from the Bowman's capsule that encloses the glomerulus. Its convoluted structure and microvilli-lined cells increase the surface area for reabsorption. The PCT reabsorbs glucose, amino acids, sodium, and water from the filtrate, ensuring essential...
900
Regulation of Water Intake
492
Osmolality refers to the number of solute particles per kilogram of solvent in a solution. Plasma osmolality specifically indicates the total number of solute particles per kilogram of water in blood plasma. This value reflects the body's hydration status and is tightly regulated through mechanisms controlling water intake and output. While water consumption is a conscious decision, the body has intrinsic regulatory systems to maintain fluid balance. Dehydration, a state of water deficit...
492
Regulation of Sodium and Potassium
475
The regulation of sodium and potassium ion concentrations in the human body is a complex process governed primarily by hormones such as aldosterone, antidiuretic hormone (ADH), and atrial natriuretic peptide (ANP).
Sodium Regulation
Sodium ions make up approximately 90% of extracellular cations, with a normal blood plasma concentration of 136–148 mEq/L. A decrease in blood volume and pressure triggers the release of renin from granular cells in the juxtaglomerular complex (JGC), primarily...
Sodium Regulation
Sodium ions make up approximately 90% of extracellular cations, with a normal blood plasma concentration of 136–148 mEq/L. A decrease in blood volume and pressure triggers the release of renin from granular cells in the juxtaglomerular complex (JGC), primarily...
475
Formation of Concentrated Urine
1.6K
There is a gradient of solutes in the interstitial fluid from the renal cortex through the medulla, known as the medullary osmotic gradient. The juxtamedullary nephrons establish and maintain this gradient using countercurrent mechanisms with loops extending deep into the medulla. These nephrons also use countercurrent mechanisms to regulate urine volume and concentration. The interaction between the descending and ascending limbs of the nephron loop creates an osmotic gradient through...
1.6K


