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当压力并非唯一罪魁祸首时:一名年轻格雷夫斯病患者的继发性肾上腺功能不全病例

When Stress Is Not the Only Culprit: A Case of Secondary Adrenal Insufficiency in a Young Patient With Graves' Disease.

作者信息

Ozair Saleha, Maldonado-Rivera Hiram, Medina-Morales Kimberly, Marti Echols, Angueira-Serrano Eugenio, Michel George

机构信息

Internal Medicine, Larkin Community Hospital, South Miami, USA.

Endocrinology, Larkin Community Hospital, South Miami, USA.

出版信息

Cureus. 2023 Jul 7;15(7):e41528. doi: 10.7759/cureus.41528. eCollection 2023 Jul.

DOI:10.7759/cureus.41528
PMID:37551210
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10404451/
Abstract

This case report underscores the significance of maintaining a broad list of differential diagnoses, including adrenal insufficiency, when evaluating patients who present with recurring episodes of hypotension and generalized fatigue. It further underscores that T3 thyrotoxicosis can manifest as the initial and sole presenting feature of Graves' disease. Finally, it emphasizes the critical importance of employing a multidisciplinary approach to discharge high-risk patients from the hospital to minimize the risk of acute decompensation.

摘要

本病例报告强调了在评估出现反复低血压发作和全身疲劳的患者时,保持包括肾上腺功能不全在内的广泛鉴别诊断清单的重要性。它进一步强调,T3甲状腺毒症可表现为格雷夫斯病的初始和唯一表现特征。最后,它强调了采用多学科方法让高危患者出院以尽量降低急性失代偿风险的至关重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e45/10404451/44c8585e2351/cureus-0015-00000041528-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e45/10404451/44c8585e2351/cureus-0015-00000041528-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e45/10404451/44c8585e2351/cureus-0015-00000041528-i01.jpg

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1
When Stress Is Not the Only Culprit: A Case of Secondary Adrenal Insufficiency in a Young Patient With Graves' Disease.当压力并非唯一罪魁祸首时:一名年轻格雷夫斯病患者的继发性肾上腺功能不全病例
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J Clin Diagn Res. 2016 Apr;10(4):OD20-2. doi: 10.7860/JCDR/2016/16395.7678. Epub 2016 Apr 1.
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Graves' Thyrotoxicosis Leading to Adrenal Decompensation and Hyperandrogenemia in a Pediatric Patient with Salt-Wasting Congenital Adrenal Hyperplasia.格雷夫斯甲状腺毒症导致一名患有失盐型先天性肾上腺皮质增生症的儿科患者出现肾上腺失代偿和高雄激素血症。
Case Rep Endocrinol. 2018 Nov 22;2018:2359205. doi: 10.1155/2018/2359205. eCollection 2018.
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Serum ratio of triiodothyronine to thyroxine, and thyroxine-binding globulin and calcitonin concentrations in Graves' disease and destruction-induced thyrotoxicosis.格雷夫斯病和破坏诱导性甲状腺毒症中血清三碘甲状腺原氨酸与甲状腺素的比值、甲状腺素结合球蛋白及降钙素浓度
J Clin Endocrinol Metab. 1981 Jul;53(1):113-6. doi: 10.1210/jcem-53-1-113.
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Relative Adrenocortical Insufficiency Following Radioactive Iodine Therapy for Graves' Disease: A Report of Two Cases.放射性碘治疗格雷夫斯病后相对肾上腺皮质功能不全:两例报告
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Ratio of serum free triiodothyronine to free thyroxine in Graves' hyperthyroidism and thyrotoxicosis caused by painless thyroiditis.格雷夫斯病甲亢和无痛性甲状腺炎所致甲状腺毒症中血清游离三碘甲状腺原氨酸与游离甲状腺素的比值
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Simple and practical parameters for differentiation between destruction-induced thyrotoxicosis and Graves' thyrotoxicosis.区分破坏所致甲状腺毒症和格雷夫斯甲状腺毒症的简单实用参数。
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本文引用的文献

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Secondary Adrenal Insufficiency: Recent Updates and New Directions for Diagnosis and Management.继发性肾上腺功能不全:诊断和治疗的最新进展和新方向。
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Group 1. Epidemiology of primary and secondary adrenal insufficiency: Prevalence and incidence, acute adrenal insufficiency, long-term morbidity and mortality.第一组:原发性和继发性肾上腺功能不全的流行病学:患病率和发病率、急性肾上腺功能不全、长期发病率和死亡率。
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Case Report of a Primary Pituitary Abscess and Systematic Literature Review of Pituitary Abscess with a Focus on Patient Outcomes.原发性垂体脓肿病例报告及垂体脓肿系统文献综述:聚焦患者预后
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Secondary Adrenal Insufficiency: Where Is It Hidden and What Does It Look Like?继发性肾上腺皮质功能减退症:隐匿于何处,表现如何?
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