Hiraiwa Tetsuya, Furutama Daisuke, Sakane Sadaki, Ito Mitsuru, Imagawa Akihisa, Kimura Fumiharu, Hanafusa Toshiaki
First Department of Medicine, Osaka Medical College, Takatsuki City, Osaka, Japan.
Med Princ Pract. 2007;16(3):230-3. doi: 10.1159/000100396.
It was the aim of this study to describe a patient with isolated adrenocorticotropic hormone deficiency presenting with a variety of involuntary movements who developed an adrenal crisis due to transient thyroiditis.
A 61-year-old man was hospitalized with a variety of involuntary movements that were suspected manifestations of metabolic encephalopathy. After admission, his general status rapidly deteriorated to a life-threatening condition that included a degree of hyponatremia. The hyponatremia and metabolic encephalopathy provided clues toward a definitive diagnosis. After corticosteroid and sodium supplementation improved the status of the patient, endocrinological examinations revealed that he suffered from isolated adrenocorticotropic hormone deficiency followed by transient thyroiditis that induced an adrenal crisis.
This case emphasizes the importance of considering hypoadrenalism when encountering hyponatremia or metabolic encephalopathy of unknown etiology.
本研究旨在描述一名患有孤立性促肾上腺皮质激素缺乏症的患者，该患者出现多种不自主运动，并因短暂性甲状腺炎引发肾上腺危象。
一名61岁男性因多种不自主运动入院，这些运动被怀疑是代谢性脑病的表现。入院后，他的一般状况迅速恶化为危及生命的状态，包括一定程度的低钠血症。低钠血症和代谢性脑病为明确诊断提供了线索。在补充皮质类固醇和钠改善患者状况后，内分泌检查显示他患有孤立性促肾上腺皮质激素缺乏症，随后出现短暂性甲状腺炎并诱发肾上腺危象。
该病例强调了在遇到病因不明的低钠血症或代谢性脑病时考虑肾上腺功能减退的重要性。
