Shimazaki Senna, Hashimoto Etaro, Kuno Haruka, Maeno Takami, Matsumoto Nako, Suzuki Masatsune, Maeno Tetsuhiro
Department of General Medicine and Primary Care, University of Tsukuba Hospital, Tsukuba, JPN.
Department of General Medicine, Mito Kyodo General Hospital, Mito, JPN.
Cureus. 2024 Apr 25;16(4):e59038. doi: 10.7759/cureus.59038. eCollection 2024 Apr.
Adrenal insufficiency often presents with nonspecific symptoms, physical findings, and laboratory results, leading to diagnostic challenges. However, reports have indicated that specific symptoms such as hypergeusia (hypersensitivity to taste) and hyperosmia (hypersensitivity to smell) can also occur. We report the case of a 60-year-old male with loss of appetite, fatigue, and polyarthralgia, where a detailed medical history revealed the cause of anorexia to be hypergeusia and hyperosmia. These specific symptoms led to the diagnosis of adrenal insufficiency. Treatment with oral steroids for secondary adrenal insufficiency resulted in the improvement of his diverse symptoms. This case illustrates that in patients presenting with chronic nonspecific symptoms, inquiring about heightened taste and smell sensitivity can prompt suspicion of adrenal insufficiency. Moreover, this case serves as a reminder that careful medical history taking in patients with nonspecific symptoms can uncover specific findings that may be diagnostic clues.
肾上腺功能不全常表现为非特异性症状、体格检查结果和实验室检查结果，导致诊断困难。然而，报告表明，也可能出现诸如味觉过敏（对味道超敏）和嗅觉过敏（对气味超敏）等特定症状。我们报告一例60岁男性病例，该患者有食欲不振、疲劳和多关节痛症状，详细的病史显示厌食的原因是味觉过敏和嗅觉过敏。这些特定症状导致了肾上腺功能不全的诊断。口服类固醇治疗继发性肾上腺功能不全使他的各种症状得到改善。该病例表明，对于出现慢性非特异性症状的患者，询问味觉和嗅觉敏感度升高情况可促使怀疑肾上腺功能不全。此外，该病例提醒我们，对有非特异性症状的患者进行仔细的病史采集可发现可能作为诊断线索的特定发现。
