Lee Ye Yeon, Cho Nan Hee, Lee Jong Won, Kim Nam Kyung, Kim Hye Soon, Kim Mi Kyung
Division of Endocrinology and Metabolism, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.
Endocrinol Metab (Seoul). 2017 Mar;32(1):83-89. doi: 10.3803/EnM.2017.32.1.83. Epub 2017 Jan 19.
Adrenal insufficiency (AI) is a life-threatening disorder caused by the deficiency of adrenal steroid hormones. This retrospective cross-sectional study investigated the characteristics of patients with AI in Korea.
All consecutive patients with suspected AI who received care at a tertiary referral center in Korea in 2014 and underwent adrenocorticotropic hormone stimulation or insulin-tolerance testing were identified through a review of medical charts. Patients diagnosed with AI were enrolled. Their demographic, clinical, and treatment details were extracted.
Of 771 patients with suspected AI, 183 (23.7%) received a definitive diagnosis. The most common reason for testing was the presence of suspicious AI-related symptoms (30.0%), followed by a history of steroid medications (23.5%). Their mean age was 66.7 years, and females predominated (67.8%). The most common symptoms were general weakness, anorexia, arthralgia, and fever. Approximately half (53.6%) had a history of steroid use. Hydrocortisone was the most common treatment (71.6%), with most patients taking a 30 mg dose (44.2%). The most common dose frequency was twice a day (78.6%). Fourteen patients were treated for adrenal crisis (n=10, 5.5%) or an intercurrent illness (n=4, 2.2%).
AI may have been caused by steroid medication use in many of the patients included in this study. The detection of AI can be improved by careful history-taking and being alert to the possibility that a patient has used steroids.
肾上腺功能不全（AI）是一种由肾上腺类固醇激素缺乏引起的危及生命的疾病。这项回顾性横断面研究调查了韩国AI患者的特征。
通过查阅病历，确定了2014年在韩国一家三级转诊中心接受治疗并接受促肾上腺皮质激素刺激或胰岛素耐量试验的所有连续疑似AI患者。确诊为AI的患者被纳入研究。提取了他们的人口统计学、临床和治疗细节。
在771例疑似AI患者中，183例（23.7%）得到明确诊断。检测的最常见原因是存在可疑的AI相关症状（30.0%），其次是有类固醇药物使用史（23.5%）。他们的平均年龄为66.7岁，女性占多数（67.8%）。最常见的症状是全身无力、厌食、关节痛和发热。约一半（53.6%）有类固醇使用史。氢化可的松是最常用的治疗药物（71.6%），大多数患者服用30毫克剂量（44.2%）。最常见的给药频率是每天两次（78.6%）。14例患者接受了肾上腺危象（n = 10，5.5%）或并发疾病（n = 4，2.2%）的治疗。
本研究纳入的许多患者中，AI可能是由类固醇药物使用引起的。通过仔细询问病史并警惕患者使用类固醇的可能性，可以提高AI的检出率。
