诊断延迟的一个案例:自身免疫性上腺炎模仿功能性胃肠道疾病
Nikhil Kumar Gupta1, Ambuj Yadav, Manohar Jha
1Department of Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India.
Annals of African medicine
|January 23, 2026
概括
自身免疫性上腺炎是原发性上腺功能不全的原因,可以模仿年轻人其他疾病. 早期诊断和类固醇治疗对于预防上腺危机至关重要.
科学领域:
- 内分泌学 在内分泌学.
- 内部医学 内部医学
背景情况:
- 自身免疫性上腺炎是主要上腺功能不充分的原因,特别是在年轻人中.
- 非特定的症状可能会推迟诊断,导致潜在的致命上腺危机.
研究的目的:
- 在年轻成年人中报告一种表现为原发性上腺功能缺陷的自身免疫上腺炎病例.
- 突出考虑非特异性症状和相关病史的患者上腺功能不足的重要性.
主要方法:
- 一个23岁的男性有结核性脑膜炎病史的病例报告.
- 临床表现包括吐,虚弱,行为改变,低血压,低血和高血.
- 实验室测试显示血清皮质醇低,ACTH升高;成像排除了结核性上腺参与.
主要成果:
- 该患者被诊断患有自身免疫性上腺炎,导致一次性上腺功能不全 (阿迪森危机).
- 用静脉注射的皮,液体和随后的口服类固醇替代治疗导致明显改善.
- 患者已在维护类固醇治疗中出院.
结论:
- 在年轻患者中,应考虑自身免疫性上腺炎,这些患者有不明原因的胃肠道或精神病学症状.
- 早期识别和及时的类固醇替代对于管理原发性上腺功能衰竭和预防上腺危机至关重要.
- 医生应该保持高度的怀疑指数,特别是在有中枢神经系统结核病病史的患者中.
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