艾滋病伴肾上腺皮质功能减退症1例报告并文献复习

AIDS complicated with adrenal insufficiency:A case report and literature review

目的:探讨艾滋病(AIDS)患者出现肾上腺皮质功能减退症(AI)时的临床特点、诊断思路及治疗方法,提高临床医生对该病的认识,为其临床诊治提供依据。方法:回顾性分析1例AIDS伴AI患者的临床资料,将诊治经过进行总结,并进行相关文献复习。结果:该患者经相关检查后明确诊断为AIDS伴AI,给予糖皮质激素(醋酸泼尼松,早上8点5.0mg,下午4点2.5mg口服)替代治疗及对症治疗,患者乏力、恶心、呕吐症状消失,食欲增加,电解质正常,好转出院。随访37d,患者因严重机会性感染死亡。结论:当AIDS患者出现无法解释的症状,如厌食、恶心、消瘦及更具特征性的表现(如体位性低血压、低钠血症或高钾血症)时应考虑到AI的可能,早期给予糖皮质激素替代治疗是可行的,疗效显著。

Objective：To explore the clinical characteristics,diagnosis,and treatments of adrenal insufficiency（AI）in the patients with acquired immune deficiency syndrome（AIDS）,and to improve the clinician＇s understanding of the disease and provide evidences for its diagnosis and treatments.Methods：The clinical data of one patient with AIDS and AI were retrospectively analyzed and the diagnosis and treatments were summarized,and the relative literatures were reviewed.Results：The patient was clearly diagnosed as AIDS and AI after relevant examinations.The symptoms such as fatigue,nausea and vomiting of the patient were disappeared,the food intake of the patient was increased,and the electrolyte was normal after some treatments such as hormone replacement therapy（oral prednisone acetate 5.0 mg at 8：00am.and 2.5 mg at 4：00pm.）and symptomatic treatments.The patient died of a severe opportunistic infection when followed up for 37 d.Conclusion：The possibility of AI should be taken into account when the patients with AIDS have unexplained symptoms such as anorexia,nausea,weight loss and more characteristic manifestations such as orthostatic hypotension,hyponatremia or hyperkalemia.Early administration of glucocorticoid replacement therapy is feasible and effective.