Tanaka Takamasa, Terada Norihiko, Fujikawa Yoshiki, Fujimoto Takushi
Department of General Internal Medicine, Tazuke-Kofukai, Medical Research Institute, Kitano Hospital, Japan.
Intern Med. 2016;55(20):2975-2978. doi: 10.2169/internalmedicine.55.6932. Epub 2016 Oct 15.
Isolated adrenocorticotropic hormone deficiency (IAD) is a rare disorder with diverse clinical presentations. A 79-year-old man was bedridden for six months due to flexion contractures of the bilateral hips and knees, along with hyponatremia. He was diagnosed with IAD based on the results of endocrine tests. After one month of corticosteroid replacement, he recovered and was able to stand up by himself. Although flexion contracture is a rare symptom of IAD, steroid replacement therapy may be effective, even for seemingly irreversibly bedridden elderly patients. In bedridden elderly patients with flexion contractures, we should consider and look for any signs of adrenal insufficiency.
孤立性促肾上腺皮质激素缺乏症（IAD）是一种临床表现多样的罕见疾病。一名79岁男性因双侧髋部和膝部屈曲挛缩以及低钠血症卧床6个月。根据内分泌检查结果，他被诊断为IAD。经过1个月的皮质类固醇替代治疗，他康复并能够自行站立。尽管屈曲挛缩是IAD的罕见症状，但类固醇替代疗法可能有效，即使对于看似不可逆卧床的老年患者也是如此。对于患有屈曲挛缩的卧床老年患者，我们应考虑并寻找肾上腺功能不全的任何迹象。
