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新冠病毒感染后新发原发性肾上腺皮质功能减退症:病例报告

NEW-ONSET PRIMARY ADRENAL INSUFFICIENCY AFTER COVID-19: CASE REPORT.

作者信息

Kayhan Y, Azizova L, Kan E K, Atmaca A, Çolak R

机构信息

Ondokuz Mayis University, Faculty of Medicine - Endocrinology and Metabolism, Samsun, Turkey.

出版信息

Acta Endocrinol (Buchar). 2024 Jan-Mar;20(1):90-92. doi: 10.4183/aeb.2024.90. Epub 2024 Oct 3.

Abstract

COVID-19 primarily affects the respiratory system. What comes after the disease is now a greater concern for the scientific world. It is remarkable for causing endocrine organ involvement, particularly in the adrenal glands. However, its effect on the adrenal gland has not been fully elucidated. A case of primary adrenal insufficiency after COVID-19. A 31-year-old female patient who presented with complaints of weakness, anorexia, nausea, recent onset of vomiting, dizziness, and low blood pressure for two months was admitted to the outpatient Department of Endocrinology and Metabolism. After discharge, the patient had routine follow-ups, and here we present the information on the first and seventh month after discharge. The patient was diagnosed with primary adrenal insufficiency with cortisol <0.054 µg/dL and adrenocorticotropic hormone >1200 pg/mL in the laboratory. In the non-contrast computed tomography taken in the adrenal protocol, the stem and leaves of both adrenal glands are significantly thinned and appear atrophic, the right adrenal gland is hardly distinguished. Hydrocortisone was started. All complaints were resolved within a week, except hyperpigmentation, which was resolved six months later after treatment. Our study support adrenal gland involvement due to COVID-19, further research is needed to obtain data on damage mechanisms.

摘要

新型冠状病毒肺炎(COVID-19)主要影响呼吸系统。该疾病之后出现的情况现在引起了科学界更大的关注。它因导致内分泌器官受累而引人注目,尤其是肾上腺。然而,其对肾上腺的影响尚未完全阐明。一例COVID-19后原发性肾上腺功能不全的病例。一名31岁女性患者因乏力、厌食、恶心、近期出现呕吐、头晕和低血压两个月而入住内分泌与代谢门诊。出院后,患者进行了常规随访,在此我们呈现出院后第一个月和第七个月的信息。实验室检查显示患者被诊断为原发性肾上腺功能不全,皮质醇<0.054µg/dL,促肾上腺皮质激素>1200pg/mL。在肾上腺协议的非增强计算机断层扫描中,双侧肾上腺的髓质和皮质显著变薄,呈现萎缩状态,右侧肾上腺几乎无法分辨。开始使用氢化可的松治疗。除色素沉着外,所有症状在一周内得到缓解,色素沉着在治疗六个月后得到缓解。我们的研究支持COVID-19导致肾上腺受累,需要进一步研究以获取损伤机制的数据。

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Inflammatory Cell Infiltration of Adrenals in COVID-19.COVID-19 中的肾上腺炎症细胞浸润。
Horm Metab Res. 2020 Sep;52(9):639-641. doi: 10.1055/a-1191-8094. Epub 2020 Jul 6.
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Endocrine and metabolic link to coronavirus infection.内分泌和代谢与冠状病毒感染的关联。
Nat Rev Endocrinol. 2020 Jun;16(6):297-298. doi: 10.1038/s41574-020-0353-9.

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