ID 113765
タイトル別表記
A case of isolated ACTH deficiency that required 6 months for the diagnosis from onset
著者
松田, 宙也 徳島大学
遠藤, ふうり 徳島大学
桝田, 志保 徳島大学
三井, 由加里 徳島大学
明比, 祐子 徳島大学
キーワード
isolated ACTH deficiency
adrenal insufficiency
anorexia
nausea
arthralgia
資料タイプ
学術雑誌論文
抄録
A 53-year-old man noticed anorexia, nausea, and arthralgia of the upper limbs in April, 201X. Since these symptoms persisted, he visited general hospital and clinic and was examined for blood chemistry, ECG, echocardiography and so on. However, he did not get a definitive diagnosis and was followed up with drip infusion of saline. The symptoms did not subside and fatigue and syncope with hypotension developed. Furthermore, he also suffered weight loss of 10 kg in few months and was referred to our hospital for more detailed examinations in October, 201X. Upon the initial examination, all his symptoms matched those of adrenal insufficiency and notable decreases of both plasma ACTH and serum cortisol level were observed. Prompt glucocorticoid supplementation improved his symptoms and the abnormal laboratory data immediately. He was diagnosed adrenal insufficiency due to isolated ACTH deficiency from the results of CRH loading test and insulin tolerance test.
Since most of the symptoms and laboratory findings are non-specific, diagnosis of adrenal insufficiency is often delayed. However, adrenal insufficiency could worsen when the patient is under stress (e.g. infection) and often be life-threatening. Glucocorticoid replacement therapy should be initiated as soon as the diagnosis is confirmed. Furthermore, educating patients and his families plays a very important role in the management of chronic adrenal insufficiency, in particular to the prevention of adrenal crisis.
掲載誌名
四国医学雑誌
ISSN
00373699
cat書誌ID
AN00102041
出版者
徳島医学会
75
1-2
開始ページ
69
終了ページ
74
並び順
69
発行日
2019-04-25
フルテキストファイル
言語
jpn
著者版フラグ
出版社版
部局
病院
医学系
先端酵素学研究所