Ohara Nobumasa, Kojima Naoyuki, Sato Takashi, Ikarashi Tomoo, Sone Hirohito, Oki Yutaka, Kamoi Kyuzi, Hara Masao, Sasaki Hideo
Department of Endocrinology and Metabolism, Niigata Medical Center, Japan.
Intern Med. 2015;54(20):2629-35. doi: 10.2169/internalmedicine.54.5022. Epub 2015 Oct 15.
A 67-year-old woman developed isolated adrenocorticotropin deficiency (IAD), which manifested as lethargy, a 20-kg body weight loss, hypoglycemia, and parkinsonism, and began corticosteroid replacement. Her symptoms resolved rapidly, and her weight returned to normal within six months. However, she then developed slowly progressive type 1 diabetes mellitus (T1D) with co-existing Hashimoto thyroiditis, and commenced insulin therapy. To our knowledge, this is the first reported case of parkinsonism associated with IAD. In addition, because diabetes mellitus, including T1D, could be latent in patients with untreated IAD, careful assessment of glucose metabolism is needed after commencing corticosteroid replacement until weight regain is achieved.
一名67岁女性出现孤立性促肾上腺皮质激素缺乏症（IAD），表现为嗜睡、体重减轻20千克、低血糖和帕金森症，随后开始接受皮质类固醇替代治疗。她的症状迅速缓解，体重在六个月内恢复正常。然而，她随后发展为缓慢进展的1型糖尿病（T1D）并伴有桥本甲状腺炎，并开始接受胰岛素治疗。据我们所知，这是首例报道的与IAD相关的帕金森症病例。此外，由于包括T1D在内的糖尿病在未经治疗的IAD患者中可能潜伏存在，因此在开始皮质类固醇替代治疗后直至体重恢复之前，需要仔细评估糖代谢情况。
