以肾上腺结节样增生伴皮质醇升高首诊的原发性肾上腺皮质功能减退症1例

Primary Adrenal Insufficiency with Adrenal Nodular Hyperplasia and Elevated Cortisol: A Case Report and Literature Review

对以肾上腺结节样增生伴早期ACTH、皮质醇升高首诊的原发性肾上腺皮质功能减退的1例病例资料进行回顾性分析。结合皮质醇、ACTH节律和水平及结核相关检测考虑为结核所致原发性肾上腺皮质功能减退症。以肾上腺结节样增生伴ACTH及皮质醇升高首发就诊的患者需警惕发生原发性肾上腺皮质功能减退症的可能,需定期监测ACTH及皮质醇的水平及节律,避免漏诊及误诊。

We report a patient of primary adrenal insufficiency with adrenal nodular hyperplasia and elevated cortisol. Combined with cortisol, ACTH rhythm and level, and tuberculosis-related testing, the primary adrenal insufficiency caused by tuberculosis was considered. Patients with adrenal nodular hyperplasia accompanied by elevated ACTH and cortisol should be alert to the possibility of primary adrenal insufficiency, and the levels and rhythm of ACTH and cortisol should be regularly monitored to avoid missed diagnosis and misdiagnosis.