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[艾迪生病危象作为肺癌患者肾上腺功能不全的首发表现]

[Addisonian crisis as first manifestation of adrenal gland insufficiency in patient diagnosed with lung cancer].

作者信息

Muñoz A, Oñate J, Mañé J M, Rubio I, Fernández R, Barceló J R, López Vivanco G

机构信息

Servicio de Oncología Médica, Hospital de Cruces, Osakidetza/SVS, Plaza de Cruces, s/n. Barakaldo 48903, Bizkaia.

出版信息

An Med Interna. 2001 Jan;18(1):35-7.

Abstract

Adrenal insufficiency or Addison's disease is actually a rare illness associated with numerous pathologies. We describe the case of a fifty years old male with lung adenocarcinoma and metastasis in both adrenal glands, who was receiving chemotherapy with mytomicin, ifosfamide and cisplatin (MIC), and was diagnosed of adrenal insufficiency as a result of acute episode addisonian crisis. Many times, the clinic symptoms of adrenal insufficiency can go unnoticed due to its low specifity and to mixing up with other syndromes. Hypoadrenalism has been described in association with many tumours, specially with non-Hodgkin's lymphoma. It seems that there is a discordance between the number of patients with bilateral metastatic adrenal destruction and the documented cases of clinic insufficiency. Once the adrenal failure is suspected, the diagnosis and hormone replacement treatment are really easy. Addison's disease ethiologies are revised putting special emphasis on those related with cancer patients.

摘要

肾上腺功能不全或艾迪生病实际上是一种与多种病理状况相关的罕见疾病。我们描述了一名50岁男性病例,该患者患有肺腺癌且双侧肾上腺转移,正在接受丝裂霉素、异环磷酰胺和顺铂(MIC)化疗,并因急性艾迪生病危象发作而被诊断为肾上腺功能不全。由于肾上腺功能不全的临床症状特异性低且易与其他综合征混淆,很多时候其症状会被忽视。肾上腺功能减退已被描述与许多肿瘤相关,特别是与非霍奇金淋巴瘤相关。双侧转移性肾上腺破坏患者的数量与记录在案的临床功能不全病例之间似乎存在不一致。一旦怀疑肾上腺功能衰竭,诊断和激素替代治疗其实很容易。本文对艾迪生病的病因进行了修订,特别强调了与癌症患者相关的病因。

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