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肾上腺脊髓神经病,原发性肾上腺皮质功能不全的罕见病因

[Adrenomyeloneuropathy, a rare cause of primary adrenal cortex insufficiency].

作者信息

Frank K, Schrecker O, Brosi K, Krause K H, Vescei P, Moser H W, Ziegler R

出版信息

Dtsch Med Wochenschr. 1986 Oct 3;111(40):1519-22. doi: 10.1055/s-2008-1068664.

Abstract

Inherited via the X chromosome, adrenomyeloneuropathy is a rare cause of primary adrenocortical insufficiency. Neurological signs are of central and peripheral demyelinization, while endocrinologically it is characterized by Addison's disease and primary testicular insufficiency. In two patients with this condition the metabolic defect in the breakdown of long-chain fatty acids was confirmed by an increased hexakosan (C 26) blood level. One patient had an isolated failure of the zona fasciculata; in the other there was clinically manifest complete adrenocortical insufficiency. Both patients had incipient hypogonadism. In the second case, neurological symptoms preceded the endocrinological ones, while in the first both the family history and the adrenocortical insufficiency led to the diagnosis. In peripheral neuropathy in a young male, attention should always be given to signs of incipient adrenocortical insufficiency.

摘要

肾上腺脑白质营养不良通过X染色体遗传,是原发性肾上腺皮质功能不全的罕见病因。神经学体征表现为中枢和外周脱髓鞘,而在内分泌学方面,其特征为艾迪生病和原发性睾丸功能不全。在两名患有这种疾病的患者中,长链脂肪酸分解代谢缺陷通过血液中二十六碳六烯酸(C 26)水平升高得到证实。一名患者仅束状带功能衰竭;另一名患者临床上表现为完全性肾上腺皮质功能不全。两名患者均有早期性腺功能减退。在第二个病例中,神经学症状先于内分泌学症状出现,而在第一个病例中,家族史和肾上腺皮质功能不全均导致了诊断。对于年轻男性的周围神经病变,应始终关注早期肾上腺皮质功能不全的体征。

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