自身免疫性多内分泌腺病综合征Ⅱ型患者因左甲状腺素治疗引起肾上腺危象一例报道并文献复习

Adrenal Crisis Provoked by Levothyroxine in Autoimmune Polyglandular Syndrome TypeⅡ:a Case Report and Literature Review

肾上腺危象是肾上腺皮质功能不全的一种危急状态,严重威胁患者的生命安全。肾上腺皮质功能不全分为原发性、继发性及三发性。Addison病是引起原发性肾上腺皮质功能不全最常见的原因,也是自身免疫性多内分泌腺病综合征(APS)的重要组成部分。APS是一种罕见的内分泌系统疾病,其特点为出现一个以上内分泌腺体自身免疫性损伤。APS主要分为APSⅠ型和APSⅡ型。本文报道了1例因左甲状腺素治疗而诱发肾上腺危象的APSⅡ型病例,并对引发肾上腺危象的原因进行了分析、讨论,旨在为临床提供更多资料。

Adrenal crisis is a life-threatening state of adrenal insufficiency that requires immediate treatment.Adrenal insufficiency is usually dividen into primary,secondary and tertiary.Addison's disease is the commonest cause of primary adrenal insufficiency,and is an important component of autoimmune polyglandular syndrome(APS).APS is a rare endocrine disease with presence of autoimmune damage of more than one endocrine glands,which includes APS typeⅠand APS typeⅡ.This article reported a APS typeⅡpatient with levothyroxine-induced adrenal crisis,with detailed analysis of the causes,hoping to offer more information for clinical practice.