Maki Sara, Kramarz Caroline, Heister Paula Maria, Pasha Kamran
Department of Acute Medicine, Hillingdon Hospital, Uxbridge, UK.
Imperial College London, London, UK.
BMJ Case Rep. 2016 May 11;2016:bcr2015213375. doi: 10.1136/bcr-2015-213375.
Addison's disease is a rare endocrine disorder that frequently presents with non-specific symptoms, but may deteriorate rapidly into life-threatening Addisonian crisis if left untreated. Diagnosis can be difficult in patients without a suggestive medical history. We describe a case of a 37-year-old man who was admitted with acute kidney injury and hyperkalaemia, resistant to treatment with insulin/dextrose and calcium gluconate. On clinical examination, he was found to be hyperpigmented; a subsequent random serum cortisol of 49 nmol/L affirmed the preliminary diagnosis of Addison's disease. The patient's hyperkalaemia improved on treatment with hydrocortisone, and a follow-up morning adrenocorticotropic hormone of 1051 ng/L confirmed the diagnosis.
艾迪生病是一种罕见的内分泌紊乱疾病，常表现为非特异性症状，但如果不治疗，可能会迅速恶化为危及生命的肾上腺危象。对于没有提示性病史的患者，诊断可能会很困难。我们描述了一例37岁男性患者，因急性肾损伤和高钾血症入院，对胰岛素/葡萄糖和葡萄糖酸钙治疗无效。临床检查发现他有色素沉着；随后随机血清皮质醇为49 nmol/L，证实了艾迪生病的初步诊断。患者的高钾血症在氢化可的松治疗后有所改善，随访时促肾上腺皮质激素水平为1051 ng/L，确诊了该疾病。
