Norès J M, Biacabe B, Bonfils P
Service de médecine interne, université Paris V, hôpital Raymond-Poincaré, Garches, France.
Rev Med Interne. 2000 Jan;21(1):95-104. doi: 10.1016/s0248-8663(00)87235-5.
Disturbances of the sense of smell have been documented in many general pathologies. The actual etiology of such impairments is often difficult to determine. The aim of the authors is to review the literature on olfactory disorders in general diseases.
Acute and chronic liver disorders are frequently associated with hyposmia, which can be improved by vitamin A intake. Renal insufficiency could induce hyposmia according to the severity of the renal disease. Olfactory disorders seem to regress after transplantation but not after dialysis. Patients with AIDS--especially neurological forms--often present with taste and smell impairments. Smell alteration can also be noted in hypothyroidism and pseudohypoparathyroidism. In addition, taste and smell impairments have been described in patients with adrenal insufficiency or Cushing's disease. Subsequent to glucocorticoid therapy, adrenal insufficiency can induce regressive olfactory hypersensitivity. Olfactory impairments in diabetic patients can be associated with diabetic macrovascular manifestations due to ischemic alterations in the olfactory neuroepithelium. Impairment of the sense of smell has been described in many systemic diseases such as Horton's arteritis and Sjögren's syndrome.
Olfactory disorders should be investigated in patients presenting one of the above-mentioned diseases.
嗅觉障碍在许多常见病症中都有记载。此类功能障碍的实际病因往往难以确定。作者的目的是综述关于一般疾病中嗅觉障碍的文献。
急慢性肝脏疾病常伴有嗅觉减退，补充维生素A可改善这种情况。肾功能不全可根据肾脏疾病的严重程度诱发嗅觉减退。嗅觉障碍在移植后似乎会有所缓解，但透析后则不然。艾滋病患者——尤其是神经型患者——常出现味觉和嗅觉障碍。甲状腺功能减退和假性甲状旁腺功能减退患者也可出现嗅觉改变。此外，肾上腺皮质功能不全或库欣病患者也有味觉和嗅觉障碍的描述。糖皮质激素治疗后，肾上腺皮质功能不全会诱发嗅觉过敏减退。糖尿病患者的嗅觉障碍可能与嗅觉神经上皮的缺血性改变导致的糖尿病大血管病变有关。嗅觉障碍在许多全身性疾病中都有描述，如 Horton 动脉炎和干燥综合征。
对于患有上述疾病之一的患者，应调查其嗅觉障碍情况。
