Nomura K, Demura H, Saruta T
Department of Medicine, Tokyo Women's Medical College.
Intern Med. 1994 Oct;33(10):602-6. doi: 10.2169/internalmedicine.33.602.
Patients with Addison's disease, newly diagnosed in the last five years were surveyed nationwide in conjunction with two past surveys. The decreasing incidence, i.e., 168 patients from 1977 to 1981 (survey 1), 108 from 1982 to 1986 (survey 2), and 74 from 1987 to 1991 (the present survey), reflects a decrease in the incidence (n = 28) of tuberculous Addison's disease, but not that (n = 36) of idiopathic Addison's, making the idiopathic form predominant for the first time in the history of the disease in Japan. Because the interval between the preceding tuberculosis and the onset of Addison's averages 32 +/- 15 years, tuberculous Addison's has a relatively late onset. Pigmentation is the most frequent symptom (90%). Other symptoms, abnormal laboratory data, and positive adrenal antibodies are observed less frequently in Japan than in North America or Europe. The types of associated disorders are also distributed differently. Adrenal CT and MRI scans have been the most useful means in differentiating between the two major types of the disease. This report focuses on features distinguishing Japanese sufferers from their western counterparts.
我们结合过去的两项调查，在全国范围内对过去五年中新诊断出的艾迪生病患者进行了调查。发病率呈下降趋势，即1977年至1981年有168例患者（调查1），1982年至1986年有108例（调查2），1987年至1991年有74例（本次调查），这反映出结核性艾迪生病的发病率（n = 28）有所下降，但特发性艾迪生病的发病率（n = 36）并未下降，这使得特发性形式在日本该病历史上首次占据主导地位。由于先前的结核病与艾迪生病发病之间的间隔平均为32±15年，结核性艾迪生病的发病相对较晚。色素沉着是最常见的症状（90%）。在日本，其他症状、异常实验室数据和肾上腺抗体阳性的出现频率低于北美或欧洲。相关疾病的类型分布也有所不同。肾上腺CT和MRI扫描一直是区分该病两种主要类型的最有用手段。本报告重点关注日本患者与西方患者的区别特征。
