三氯醋酸诱导的肾上腺功能不全引起的低钠血症和癫痫发作。
Hyponatremia and seizures caused by triamcinolone-induced adrenal insufficiency.
机构信息
University of Münster, Medizinische Klinik und Poliklinik D, Albert-Schweitzer Strasse 33, 48149 Münster, Germany.
出版信息
Nat Rev Nephrol. 2010 Feb;6(2):117-23. doi: 10.1038/nrneph.2009.215.
BACKGROUND
A 49-year-old woman presented to hospital with an 18-month history of hyponatremic episodes, nausea, vomiting, anorexia and fatigue.
INVESTIGATIONS
Physical examination, laboratory tests including full blood count, measurement of electrolytes, hormones, autoantibodies, thyroid and renal function, corticotropin-releasing-hormone stimulation test, 24 h urinalysis and abdominal ultrasonography.
DIAGNOSIS
Severe symptomatic hyponatremia in a patient with secondary adrenal insufficiency caused by treatment of lumbago with triamcinolone injections.
MANAGEMENT
Hydrocortisone replacement therapy (15 mg daily) for 3 months, followed by a tapering schedule over 12-24 months.
背景
一名 49 岁女性因低钠血症发作、恶心、呕吐、厌食和疲劳就诊，病史已有 18 个月。
检查
体格检查、全血细胞计数和电解质、激素、自身抗体、甲状腺和肾功能检测，促肾上腺皮质激素释放激素刺激试验，24 小时尿液分析和腹部超声检查。
诊断
腰痛接受曲安奈德注射治疗后，发生严重症状性低钠血症和继发性肾上腺功能不全。
治疗
氢化可的松替代治疗（每日 15 毫克）3 个月，然后在 12-24 个月内逐渐减少剂量。
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