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首页> 外文期刊>KYAMC Journal >Diagnosis and Management of Addison's Disease in a Nulliparous Woman followed by Successful Pregnancy Outcome in a Rural Tertiary Hospital: A Case Report
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Diagnosis and Management of Addison's Disease in a Nulliparous Woman followed by Successful Pregnancy Outcome in a Rural Tertiary Hospital: A Case Report

机译：一例乡村三级医院的无脂肪妇女艾迪生氏病的诊断与治疗及成功的妊娠结局

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Introduction: Addison's disease is a relatively rare endocrine condition requiring life-long glucocorticoid and mineralcorticoid replacement therapy. Women with Addison's disease may have a reduced parity. Addisonian crises, a rare but life-threatening event in pregnant women, may accompany stressful conditions such as labor, puerperium, infection, hyperemesis gravidarum or surgery. Case Presentation: This is a case report of previously healthy 24-year-old nulliparous woman presented with a history of fatigue, fever, diarrhoea and skin darkening. She had pale conjunctiva, low blood pressure, tachycardia, some dehydration, hyperpigmentation of palmer creases, knuckles, buccal mucosa and face. Her serum cortisol was low and rapid ACTH stimulation test with Synacthen showed a poor cortisol response. Patient was immediately managed with IV steroid and later dicharged with oral steroid. After 6 months she became pregnant and the steroid therapy was regulated to avoid adrenal crisis during pregnancy. The patient underwent to caesarean section at 38th week and gave birth to a normal baby. Conclusion: Addisonian crisis represents an endocrine emergency that requires a correct diagnosis with prompt and appropriate salt and steroid replacements to save the patient. Though Addison's disease in women is a risk factor for an adverse pregnancy outcome, it is believed that appropriately treated patients can expect to have uneventful pregnancies of normal duration and without fetal compromise. KYAMC Journal Vol. 7, No.-2, Jan 2017, Page 814-817
机译：简介：艾迪生氏病是一种相对罕见的内分泌疾病，需要终生糖皮质激素和盐皮质激素替代疗法。患有艾迪生氏病的妇女的平价可能会降低。 Addisonian危机是孕妇中罕见但危及生命的事件，可能伴随着诸如劳动，产褥期，感染，妊娠呕吐或手术等应激性疾病。病例报告：这是一个先前健康的24岁未产妇的病例报告，该患者曾有疲劳，发烧，腹泻和皮肤变黑的病史。她的结膜苍白，血压低，心动过速，脱水，手掌皱痕，关节，颊粘膜和面部色素沉着过多。她的血清皮质醇水平低，使用Synacthen进行的ACTH快速刺激试验显示皮质醇反应不良。患者立即接受静脉类固醇治疗，随后口服口服类固醇。 6个月后，她怀孕了，并调整了类固醇疗法以避免怀孕期间的肾上腺危机。该患者在第38周接受了剖腹产，并生了一个正常的婴儿。结论：Addisonian危机代表内分泌紧急情况，需要正确诊断并及时，适当地补充盐和类固醇以挽救患者。尽管女性的艾迪生氏病是导致不良妊娠结局的危险因素，但据信，经过适当治疗的患者可以期待正常持续时间的正常妊娠，并且不会损害胎儿。 KYAMC杂志第一卷7，No.-2，2017年1月，第814-817页

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