King M S
Northwestern University Medical School, Chicago, USA.
J Am Board Fam Pract. 1999 Sep-Oct;12(5):386-90. doi: 10.3122/jabfm.12.5.386.
Adrenal insufficiency is a rare condition that can cause common and nonspecific symptoms. One such symptom, reported by all patients with adrenal insufficiency, is fatigue. On the other hand, up to 20% of patients seeking care from primary care physicians will have fatigue as a complaint. Only a small percentage of patients are found to have underlying medical disease.
A MEDLINE literature search was performed from 1966 to the present using the key words "fatigue," "adrenal insufficiency," and "polyglandular autoimmune endocrinopathy." Major endocrinology textbooks were also referenced. In addition, references were obtained from bibliographies of available articles.
This article describes a patient with adrenal insufficiency and fatigue as the primary complaint. A brief discussion of fatigue and clues to organic causes follows, along with a more detailed discussion of adrenal insufficiency. Important medical history or signs and symptoms of organic disease suggest the need for screening tests and more detailed evaluation to uncover the uncommon medical causes of fatigue.
肾上腺功能不全是一种罕见疾病，可引发常见且非特异性的症状。肾上腺功能不全患者均会出现的一种症状是疲劳。另一方面，在寻求初级保健医生诊治的患者中，高达20%会主诉疲劳。仅有一小部分患者被发现存在潜在的内科疾病。
使用关键词“疲劳”“肾上腺功能不全”和“多腺体自身免疫性内分泌病”对1966年至今的MEDLINE文献进行检索。还参考了主要的内分泌学教科书。此外，从现有文章的参考文献中获取资料。
本文描述了一名以肾上腺功能不全和疲劳为主要主诉的患者。随后简要讨论了疲劳及器质性病因的线索，以及对肾上腺功能不全更详细的讨论。重要的病史或器质性疾病的体征和症状提示需要进行筛查试验和更详细的评估，以发现导致疲劳的罕见内科病因。
