Shapiro M, Zalewski S, Steiner Z, Bernheim J, Nabriski D, Taragan R, Bruderman I, Shenkman L
Isr J Med Sci. 1984 May;20(5):381-7.
Over a 14-year period, 26 patients with adrenal insufficiency of multiple etiology were evaluated. Eight were diagnosed at autopsy, six of whom had acute bilateral adrenal hemorrhage. Nine had chronic adrenal insufficiency. Of these, five were idiopathic and three had polyglandular disorders. Four others had tuberculosis. Six of nine patients with chronic adrenal insufficiency were hyperpigmented. Unusual manifestations of adrenal hypocorticism included hypercalcemia, flaccid paralysis, and joint contractures. The presence of multiple hormonal deficiencies focused the diagnosis on hypopituitarism. Two cases of isolated ACTH deficiency were detected. Patients with familial Mediterranean fever with amyloidosis commonly presented with reduced adrenal reserve rather than overt insufficiency. Metastatic cancer of the adrenal glands was a rare cause of reduced adrenal reserve.
在14年期间，对26例多种病因所致肾上腺功能不全的患者进行了评估。8例在尸检时被诊断，其中6例有急性双侧肾上腺出血。9例有慢性肾上腺功能不全。其中，5例为特发性，3例有多腺体疾病。另外4例有结核病。9例慢性肾上腺功能不全患者中有6例有色素沉着。肾上腺皮质功能减退的不寻常表现包括高钙血症、弛缓性麻痹和关节挛缩。多种激素缺乏的存在使诊断集中在垂体功能减退上。检测到2例孤立性促肾上腺皮质激素缺乏。伴有淀粉样变性的家族性地中海热患者通常表现为肾上腺储备减少而非明显的功能不全。肾上腺转移癌是肾上腺储备减少的罕见原因。
