特发性联合促肾上腺皮质激素和生长激素缺乏症模拟慢性疲劳综合征。
Idiopathic combined adrenocorticotropin and growth hormone deficiency mimicking chronic fatigue syndrome.
机构信息
Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
Center for Education in Medicine and Health Sciences, Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.
出版信息
BMJ Case Rep. 2021 Oct 22;14(10):e244861. doi: 10.1136/bcr-2021-244861.
A 42-year-old man who had suffered from severe fatigue for 5 years was diagnosed as having chronic fatigue syndrome (CFS) and fibromyalgia. Endocrinological workup using combined anterior pituitary function tests showed that the patient had adrenocorticotropin hormone (ACTH) deficiency, with a normal pituitary MRI. Treatment with a physiologic dose of oral hydrocortisone replacement physically ameliorated his general fatigue. A secondary workup using a growth hormone-releasing peptide-2 test revealed that he also had growth hormone (GH) deficiency, and GH replacement therapy was started. His muscle pain and depression were improved by the therapy. Here, we present a rare case of combined deficiency of ACTH and GH in a middle-aged man with severe general fatigue. This case report aims to raise awareness of combined deficiency of ACTH and GH as a differential diagnosis of CFS and its mimics.
一位 42 岁的男性，患有严重疲劳 5 年，被诊断为慢性疲劳综合征（CFS）和纤维肌痛。使用联合垂体前叶功能测试的内分泌学检查显示，患者存在促肾上腺皮质激素（ACTH）缺乏，垂体 MRI 正常。使用生理剂量的口服氢化可的松替代治疗显著改善了他的全身疲劳。使用生长激素释放肽-2 测试进行的二次检查显示，他还存在生长激素（GH）缺乏，开始进行 GH 替代治疗。他的肌肉疼痛和抑郁症状通过治疗得到改善。在这里，我们报告了一例罕见的中年男性严重全身疲劳合并 ACTH 和 GH 缺乏的病例。本病例报告旨在提高对 ACTH 和 GH 联合缺乏作为 CFS 及其类似疾病的鉴别诊断的认识。
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