Tamiya Hiroyuki, Ishikawa Akihisa, Mano Shinya, Kamoshida Toshiro, Hirai Shinji, Chikatsu Noriko, Oka Yuji
Department of Internal Medicine, Hitachi General Hospital, Hitachi, Ibaraki, Japan.
BMJ Case Rep. 2010 Dec 29;2010:bcr1020103384. doi: 10.1136/bcr.10.2010.3384.
Isolated adrenocorticotropic hormone (ACTH) deficiency (IAD) is a potentially fatal condition that is difficult to diagnose. The authors diagnosed IAD in a patient who presented with recurrent oesophageal ulceration resulting in oesophageal stenosis. The recurrent oesophageal ulcers were due to frequent nausea and vomiting that were the presenting digestive symptoms of adrenal insufficiency. Severe hypoglycaemia during this patient's course suggested the diagnosis of adrenal insufficiency. This case is educational because digestive symptoms are the most common symptoms in patients with adrenal insufficiency, but the diagnosis of adrenal insufficiency in such patients is not easy.
孤立性促肾上腺皮质激素（ACTH）缺乏症（IAD）是一种难以诊断的潜在致命疾病。作者在一名因反复出现食管溃疡导致食管狭窄的患者中诊断出IAD。反复出现的食管溃疡是由于频繁恶心和呕吐所致，而恶心和呕吐是肾上腺功能不全的首发消化症状。该患者病程中出现的严重低血糖提示肾上腺功能不全的诊断。这个病例具有启发性，因为消化症状是肾上腺功能不全患者最常见的症状，但在此类患者中诊断肾上腺功能不全并不容易。
