爱迪生氏病

title: 症状.
content: 爱迪生氏病的症状微小不易诊断,常见症状包含疲倦、直立时头晕、头痛、肌肉无力、站立困难、发烧、体重减轻、焦躁、头晕呕吐、腹泻、多汗、人格/情绪变化、关节及肌肉疼痛。部分病患会因为尿液排泄过多钠而追求重咸饮食。色素沉积的现象增加。
title: 临床症状.
content: 检测结果如下:
title: 爱迪生氏危症.
content: 肾上腺严重失调时发生,可能肇因于:长期未诊断出的爱迪生氏病、肾上腺出血、或是既有患病者遭逢感染或创伤。属医疗危急情形,若缺乏即时治疗将威胁患者性命。 症状包含:
title: 病因.
content: 肾上腺机能不足可以依据影响该器官的方法而作出区分,最终皆导致肾上腺无法分泌足够的皮质醇。包含:肾上腺发育不全、类固醇分泌功能不全、及肾上腺受损。 引发爱迪生氏病的疾病包括自体免疫系统障碍、结核病、HIV(人类免疫缺陷病毒)等,其中自体免疫系统障碍占已开发国家中的绝大部分,称为AAD(autoimmune Addison’s disease)。受到基因或环境因子的影响,肾上腺皮质会逐渐地被破坏,取而代之的则是纤维组织,即便肾上腺皮质细胞不断地流失,AAD也会长期维持在无症状的情况,直到90%以上的细胞被破坏才会产生明显的症状,无症状的情况可以维持数月甚至数年。当肾上腺皮质受到病毒感染,会进而导致可以识别自身抗体21-hydroxylase(21OH)的CD4+T细胞、CD8+T细胞及B细胞释放穿孔素与颗粒酶等方式破坏肾上腺皮质细胞,导致肾上腺皮质失能,无法分泌足量的糖皮质素(glucocorticoids)以及盐皮质素(mineralocorticoids),分别使皮质醇(cortisol)和醛固酮(aldosterone)分泌不足,其中,盐皮质素浓度降低会增加高钾血症(hyperkalemia)的风险。

Summary: 爱迪生氏病(英语:Addison’s disease),又称原发性肾上腺功能不全(英语:primary adrenal insufficiency)及皮质醇过少(英语:hypocortisolism),是一种长期性内分泌疾病,因人体肾上腺无法制造足够类固醇激素而致病。通常病情进展并不快,可能的病征有腹痛、虚弱感及体重下降,身体某些部位的皮肤颜色变得暗沉等。患者可能会因受伤、手术或感染等状况带来的压力诱发肾上腺危象,导致休克、呕吐、下背痛及昏迷。 此症肇因于肾上腺无法产生足够的固醇类激素皮质醇和醛固酮;在已开发国家中主要病因为罹患自体免疫性疾病,而在开发中国家则多由罹患结核病引起。其他的病因为使用特定药物、罹患败血症和两侧肾上腺内出血等。次发性肾上腺功能不足是因脑下垂体制造的促肾上腺皮质激素或下视丘制造的促肾上腺皮质激素释放激素不足。尽管有其差异,但肾上腺危象是可能发生在所有类型的肾上腺功能不足的。此症须基于血液检查、尿液分析和医学影像的结果来做确诊。 治疗方法为补充缺乏的激素,意即服用皮质类固醇如皮质醇和氟氢可的松,前述药物通常以口服为主。患者需要注意终身且持续性地补充类固醇,定期追踪并监测其他健康问题;有些患者可能需要采用高盐饮食。若患者的症状恶化,会建议从静脉注射皮质类固醇激素,且患者应随身携带备用针剂。患者通常需要静脉注射大量的点滴注射液和葡萄糖;若不接受治疗,出现肾上腺危象则可能致命。 在已开发国家中,每一万人中约有 0.9 到 1.4 人罹患此症(意即“原发性”肾上腺功能不全),患者主要为中年女性。次发性肾上腺功能不全则相对普遍。接受长期治疗的患者效果通常都很好。此症命名由来是毕业于爱丁堡大学医学院的Thomas Addison医生,他正是最早在 1855 年留下此症记叙的人。此外,形容词 “addisonian” 也用于描述爱迪生氏病的症状,和泛指爱迪生氏病患者。

Addison's disease: Addison's disease, also known as primary adrenal insufficiency and hypocortisolism, is a long-term endocrine disorder in which the adrenal glands do not produce enough steroid hormones. Symptoms generally come on slowly and may include abdominal pain, weakness, and weight loss. Darkening of the skin in certain areas may also occur. Under certain circumstances, an adrenal crisis may occur with low blood pressure, vomiting, lower back pain, and loss of consciousness. An adrenal crisis can be triggered by stress, such as from an injury, surgery, or infection. Addison's disease arises from problems with the adrenal gland such that not enough of the steroid hormone cortisol and possibly aldosterone are produced, most often due to damage by the body's own immune system in the developed world and tuberculosis in the developing world. Other causes include certain medications, sepsis, and bleeding into both adrenal glands. Secondary adrenal insufficiency is caused by not enough adrenocorticotropic hormone (ACTH) (produced by the pituitary gland) or corticotropin-releasing hormone (CRH) (produced by the hypothalamus). Despite this distinction, adrenal crises can happen in all forms of adrenal insufficiency. Addison's disease is generally diagnosed by blood tests, urine tests, and medical imaging. Treatment involves replacing the absent hormones. This involves taking a corticosteroid such as hydrocortisone and fludrocortisone. These medications are usually taken by mouth. Lifelong, continuous steroid replacement therapy is required, with regular follow-up treatment and monitoring for other health problems. A high-salt diet may also be useful in some people. If symptoms worsen, an injection of corticosteroid is recommended and people should carry a dose with them. Often, large amounts of intravenous fluids with the sugar dextrose are also required. Without treatment, an adrenal crisis can result in death. Addison's disease affects about 0.9 to 1.4 per 10,000 people in the developed world. It occurs most frequently in middle-aged females. Secondary adrenal insufficiency is more common. Long-term outcomes with treatment are typically good. It is named after Thomas Addison, a graduate of the University of Edinburgh Medical School, who first described the condition in 1855. The adjective "addisonian" is used to describe features of the condition, as well as people with Addison's disease.