抗磷脂抗体综合征引发原发性肾上腺皮质功能不全的临诊应对  

Approach to the primary adrenal insufficiency caused by anti-phospholipid syndrome

作　　者：王敏[1] 邱雪婷 王嫱[2] 杨涛[1] 孙敏[1] Wang Min;Qiu Xueting;Wang Qiang;Yang Tao;Sun Min(Department of Endocrinology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China;Department of Rheumatology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院内分泌科,210029 [2]南京医科大学第一附属医院风湿免疫科,210029

出　　处：《中华内分泌代谢杂志》2021年第9期830-835,共6页Chinese Journal of Endocrinology and Metabolism

基　　金：国家重点研发计划课题(2018YFC1314800、2018YFC1314805)。

摘　　要：原发性肾上腺皮质功能不全(primary adrenal insufficiency,PAI)病因多种多样,但抗磷脂抗体综合征(anti-phospholipid syndrome,APS)这一病因相对罕见,且PAI的临床表现特异性不强,常难以被识别。本研究报道1例以腹痛为首发症状就诊的患者,病程中出现感染、血栓事件、乏力进行性加重等表现,经过一系列的实验室检查、影像学及病理学证实诊断为APS导致的PAI。希望在此病例报道基础上结合文献回顾,提高临床上对该类疾病的认识,避免误诊漏诊。The causes of primary adrenal insufficiency(PAI)are varying,however,anti-phospholipid syndrome(APS)is a relatively rare one.PAI lacks unique clinical manifestations,so the confirmation of PAI was easily to be neglected by physicians.We report a case with abdominal pain as the first complaint,followed by multiple infections,thrombotic events,and aggravating fatigue.Through a series of the laboratory examination,medical imaging,and pathology examination,this patient was diagnosed as PAI caused by APS.Combining this report with literature review,we aim to raise awareness of the disease and avoid misdiagnosis and missed diagnosis.

关 键 词：原发性肾上腺皮质功能不全 抗磷脂抗体综合征 肾上腺出血性梗死 

分 类 号：R593.2[医药卫生—内科学] R586[医药卫生—临床医学]