Department of Cardiology, Cardiovascular Institute of Chengdu Third People's Hospital/The Affiliated Hospital of Southwest Jiaotong University, Chengdu, 610031, China.
Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
BMC Cardiovasc Disord. 2023 Jan 29;23(1):54. doi: 10.1186/s12872-023-03079-0.
Addison's disease which is due to dysfunction of the adrenal gland, with abnormal secretion of glucocorticoids and mineralocorticoids, is rare. By inducing inflammation and disorders of water and electrolyte metabolism, Addison's disease may accelerate progression of co-existed cardiovascular diseases. Addison's disease combined with cardiovascular disease is infrequent, only 10 cases in the literature.
We reported a 51-year-old male patient with unstable angina pectoris and hypotension. Changes on coronary angiography within 2 years suggested rapid progression of coronary artery disease in a patient with low cardiovascular risk. An additional clue of skin hyperpigmentation, fatigue and further examination confirmed the diagnosis of Addison's disease caused by adrenal tuberculosis. After hormone replacement treatment, the frequency and severity of the angina pectoris were alleviated significantly, as were hypotension, hyperpigmentation and fatigue.
The combination of Addison's disease and coronary artery disease in one patient is rare. Addison's disease can induce inflammation and disorders of water and electrolyte metabolism, which may further accelerate the course of coronary artery disease. Meanwhile, the hypotension in Addison's disease may affect the coronary blood flow, which may result in an increased susceptibility to unstable angina in the presence of coronary stenosis. So, we should analyze comprehensively if the coronary artery disease progress rapidly.
由于肾上腺功能障碍导致糖皮质激素和盐皮质激素分泌异常的艾迪生病较为罕见。艾迪生病可通过诱发炎症和水、电解质代谢紊乱，加速并存的心血管疾病进展。艾迪生病合并心血管疾病并不常见，文献中仅有 10 例。
我们报告了 1 例 51 岁男性不稳定型心绞痛伴低血压患者。该患者在 2 年内冠状动脉造影的变化提示低心血管风险患者的冠状动脉疾病进展迅速。皮肤色素沉着、疲劳等其他线索，进一步检查后确诊为肾上腺结核导致的艾迪生病。激素替代治疗后，心绞痛的发作频率和严重程度明显减轻，低血压、皮肤色素沉着和疲劳也有所改善。
在同一患者中艾迪生病和冠状动脉疾病同时存在较为罕见。艾迪生病可诱发炎症和水、电解质代谢紊乱，可能进一步加速冠状动脉疾病的进程。同时，艾迪生病中的低血压可能影响冠状动脉血流，使冠状动脉狭窄患者更易发生不稳定型心绞痛。因此，如果冠状动脉疾病进展迅速，我们应进行全面分析。
