Miell J, Wassif W, McGregor A, Butler J, Ross R
Department of Medicine, King's College Hospital School of Medicine, London, UK.
Postgrad Med J. 1991 Aug;67(790):770-2. doi: 10.1136/pgmj.67.790.770.
A 35 year old woman was admitted with acute radial artery occlusion necessitating two operations and thrombolytic therapy. Subsequently a diagnosis of primary hypothyroidism was made and she was commenced on thyroxine replacement therapy. Her condition, however, continued to deteriorate with the development of an Addisonian crisis heralded by, and complicated by, severe, life-threatening hypercalcaemia. This case highlights the importance of considering Addison's disease in any patient whose condition deteriorates after the introduction of thyroxine replacement, and illustrates the often forgotten association of hypercalcaemia and hypoadrenalism.
一名35岁女性因急性桡动脉闭塞入院,需要进行两次手术及溶栓治疗。随后诊断为原发性甲状腺功能减退症,并开始接受甲状腺素替代治疗。然而,她的病情继续恶化,出现了艾迪生病危象,伴有严重的、危及生命的高钙血症,这既预示着危象的发生,又使其病情复杂化。该病例强调了在任何接受甲状腺素替代治疗后病情恶化的患者中考虑艾迪生病的重要性,并说明了高钙血症与肾上腺皮质功能减退症之间常常被遗忘的关联。