Young M C, Hughes I A
Department of Child Health, University of Wales College of Medicine, Cardiff, UK.
Acta Paediatr Scand. 1991 Jan;80(1):120-4. doi: 10.1111/j.1651-2227.1991.tb11744.x.
A 14-year-old girl with congenital adrenal hyperplasia showed rapid conversion from undertreatment to overtreatment when primidone, used to treat coexistent epilepsy, was withdrawn while on a constant steroid dose. In addition to signs of hypercortisolism and a decrease in random measurements of plasma testosterone and 170H-progesterone concentrations, the deterioration in control was also illustrated by changes in the pattern of blood spot steroid profiles. Adequate control was achieved only after a 3-fold reduction in steroid dose. The decrease in dose requirement was probably the result of a reversal of liver enzyme induction consequent upon the withdrawal of primidone.
一名患有先天性肾上腺增生的14岁女孩，在维持恒定类固醇剂量的同时停用用于治疗并存癫痫的扑米酮后，出现了从治疗不足迅速转变为治疗过度的情况。除了皮质醇增多症的体征以及血浆睾酮和17α-羟孕酮浓度随机测量值降低外，血斑类固醇谱模式的变化也表明病情控制恶化。仅在将类固醇剂量降低3倍后才实现了充分控制。剂量需求的降低可能是停用扑米酮后肝酶诱导作用逆转的结果。
