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坦氏综合征 1 例报告。

Schmidt´s syndrome found by tan: a case report.

机构信息

Internal Medicine Department, Centro Hospitalar Tondela Viseu, Viseu, Portugal.

出版信息

Pan Afr Med J. 2024 Jun 10;48:53. doi: 10.11604/pamj.2024.48.53.35130. eCollection 2024.

DOI:10.11604/pamj.2024.48.53.35130
PMID:39315067
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11419569/
Abstract

Addison´s disease can form part of type 2 autoimmune polyglandular syndrome. The article reports the case of a 41-year-old female patient with hypothyroidism and vitiligo, who came to the emergency department complaining of asthenia that had worsened in recent months, as well as anorexia, nausea, and weight loss (6 kg in a year). Cutaneous hyperpigmentation was the main finding on physical examination, together with vitiligo lesions on the face, hands, and armpits. Further study revealed a low serum cortisol level, normal urine-free cortisol, and an elevated adrenocorticotropic hormone (ACTH). Antiperoxidase antibodies and 17-alpha-hidroxylase antibodies were both positive. Treatment was started with prednisolone and fludrocortisone, and a good clinical response was obtained. This case report aims to draw attention to the high level of clinical suspicion required to diagnose Addison´s disease and the need to screen actively for other potentially associated autoimmune diseases that may be associated.

摘要

艾迪生病可作为 2 型自身免疫性多腺体综合征的一部分。本文报道了一例 41 岁女性甲状腺功能减退症和白癜风患者的病例,因近几个月乏力加重,伴厌食、恶心和体重减轻(1 年内减轻 6kg),至急诊就诊。体格检查主要发现皮肤色素沉着,同时面部、手部和腋窝有白癜风病变。进一步检查发现血清皮质醇水平低,尿游离皮质醇正常,促肾上腺皮质激素(ACTH)升高。抗过氧化物酶抗体和 17-α-羟化酶抗体均为阳性。开始给予泼尼松龙和氟氢可的松治疗,获得良好的临床反应。本病例报告旨在引起对诊断艾迪生病所需的高度临床怀疑,并强调需要积极筛查可能与之相关的其他潜在相关自身免疫性疾病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c4c/11419569/d1b7e4150900/PAMJ-48-53-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c4c/11419569/d1b7e4150900/PAMJ-48-53-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c4c/11419569/d1b7e4150900/PAMJ-48-53-g001.jpg

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本文引用的文献

1
Case of autoimmune polyglandular syndrome type 2: how we uncovered the diagnosis.2型自身免疫性多内分泌腺综合征病例:我们是如何确诊的。
BMJ Case Rep. 2019 Feb 26;12(2):e227187. doi: 10.1136/bcr-2018-227187.
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Autoimmune Polyendocrine Syndromes.自身免疫性多内分泌综合征
N Engl J Med. 2018 Mar 22;378(12):1132-1141. doi: 10.1056/NEJMra1713301.
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Diagnosis and classification of Addison's disease (autoimmune adrenalitis).Addison 病(自身免疫性肾上腺炎)的诊断和分类。
Autoimmun Rev. 2014 Apr-May;13(4-5):408-11. doi: 10.1016/j.autrev.2014.01.025. Epub 2014 Jan 11.
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Autoimmune polyendocrine syndromes.自身免疫性多内分泌腺综合征。
Autoimmun Rev. 2014 Feb;13(2):85-9. doi: 10.1016/j.autrev.2013.07.006. Epub 2013 Sep 18.
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Autoimmune polyglandular syndrome Type 2: the tip of an iceberg?2型自身免疫性多腺体综合征:冰山一角?
Clin Exp Immunol. 2004 Aug;137(2):225-33. doi: 10.1111/j.1365-2249.2004.02561.x.
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Polyglandular autoimmune syndromes: immunogenetics and long-term follow-up.多腺体自身免疫综合征:免疫遗传学与长期随访
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Adrenal insufficiency.肾上腺功能不全
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