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急性精神状态改变作为自身免疫性多腺体综合征II型和中风患者肾上腺功能不全的首发特征。

Acute mental status change as the presenting feature of adrenal insufficiency in a patient with autoimmune polyglandular syndrome type II and stroke.

作者信息

Watson Sara, Raj Shekar, Eugster Erica, Sanchez Juan

出版信息

J Pediatr Endocrinol Metab. 2014 May;27(5-6):545-8. doi: 10.1515/jpem-2013-0201.

Abstract

Primary adrenal insufficiency (AI) in children usually presents with non-specific symptoms such as fatigue, nausea, vomiting, and anorexia. Here, we report an unusual case of a 15 year old girl who presented with acute mental status change and was ultimately diagnosed with AI due to autoimmune polyglandular syndrome type II (APS2). Central nervous system imaging revealed a cerebral infarction. To our knowledge, the constellation of APS2, stroke and acute mental status change has not been previously reported. We review the literature with regard to the presentation of AI as well as the association between vasculitis and APS2.

摘要

儿童原发性肾上腺皮质功能减退症(AI)通常表现为疲劳、恶心、呕吐和厌食等非特异性症状。在此,我们报告一例罕见病例,一名15岁女孩出现急性精神状态改变,最终被诊断为继发于Ⅱ型自身免疫性多腺体综合征(APS2)的AI。中枢神经系统影像学检查显示有脑梗死。据我们所知,APS2、中风和急性精神状态改变这一组合情况此前尚未见报道。我们回顾了关于AI表现以及血管炎与APS2之间关联的文献。

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本文引用的文献

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Presentation of primary adrenal insufficiency in childhood.儿童原发性肾上腺皮质功能不全的表现。
J Clin Endocrinol Metab. 2011 Jun;96(6):E925-8. doi: 10.1210/jc.2011-0015. Epub 2011 Apr 6.
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Diagnosis and management of polyendocrinopathy syndromes.多内分泌腺病综合征的诊断与管理
Endocrinol Metab Clin North Am. 2009 Jun;38(2):419-36, x. doi: 10.1016/j.ecl.2009.01.007.

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