PDF(Pubmed)
Abstract：
Adrenal insufficiency (AI) is a rare but potentially life-threatening endocrine disorder characterized by inadequate production or impaired response to adrenal hormones. Symptoms may range from acute emergent crisis presenting as hemodynamic shock or may be more chronic in presentation with a gradual onset of nonspecific symptoms. These vague symptoms are often accompanied by typical laboratory findings, such as hyponatremia, hypotension, and hyperkalemia, and point toward a diagnosis of chronic AI. In this case presentation, we demonstrate chronic AI presenting with severe hyponatremia, which was revealed after return to an euvolemic baseline. Because of an insidious presentation, AI can be both an incidental finding and easily missed. This case highlights the importance of evaluating suspected cases of AI at a baseline metabolic and hemodynamic state, including volume status. High clinical suspicion is warranted in these patients to avoid potential emergent adrenal crisis and to provide appropriate replacement therapy once etiology is established.
摘要：
肾上腺功能不全（AI）是一种罕见但可能危及生命的内分泌疾病，其特征是产生不足或对肾上腺激素的反应受损。症状可能是以血流动力学休克为表现的急性突发危象，也可能是以非特异性症状逐渐发作为表现的更慢性。这些模糊的症状通常伴随着典型的实验室检查结果，比如低钠血症，低血压,和高钾血症,并指向慢性AI的诊断。在这种情况下，我们证明慢性AI表现为严重低钠血症，这是在回到正常血容量基线后发现的。因为一个阴险的演讲，人工智能既可以是偶然的发现，也很容易被错过。该案例强调了在基线代谢和血液动力学状态下评估可疑AI病例的重要性。包括卷状态。这些患者需要高度的临床怀疑，以避免潜在的紧急肾上腺危象，并在病因确定后提供适当的替代疗法。
