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A Case of Addison's Disease with Only Progressive Skin Pigmentation

Received: 14 September 2018     Accepted: 3 December 2018     Published: 4 January 2019
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Abstract

A 47 years old woman presented with darkening skins on exposed and frictional areas for more than one year, in addition to fatigue, loss of appetite and weight loss for 2 months. One year ago, there was no inducement of pigmentation on the back of the hand, and it spread to the elbow. Then, the skin of the chest, lower limbs, abdomen, neck, forehead, and internal eyelids also gradually appeared diffuse dark spots. Meanwhile she had low 24-hour urinary excretion of 17-hydroxy steroid and increased ACTH. X-ray test showed point-like calcification shadow on bilateral lungs; CT test showed increased adrenal gland volume, substantially uninformed density, and multiple stippled calcification. Histopathological results: Chromatophilic cells and macrophages that were arranged in nests, scattered and pigment-laden can see subepidermally. Diagnosis: Addison’s disease. After 6 months anti-TB and glucocorticoid hormone replacement therapy, the patient had a good general condition, disappeared clinical symptoms as well as laboratory and imaging test results returned to normal. Now no drugs have been administrated except for 2.5mg of prednisone tablets to take at a draught every morning. The patient is still traced and observed. The study in this case suggests that clinicians should be highly vigilant against Addison's disease in patients who are treated with multiple skin progressive pigmentation.

Published in Asia-Pacific Journal of Medicine (Volume 1, Issue 1)
Page(s) 10-13
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Skins Darkening, ACTH, Tuberculosis, Addison’s Disease

References
[1] Alebiosu CO,Odusan O. Addison’s Disease: A case report [J]. Annals of African Medicine, 2003, 2(2):85-87.
[2] Choudhary S, Alam A,Dewan V, et al. An Unusual Presentation of Addison’s Disease -A Case Report S[J].Clin Pediatr Endocrinol, 2011,20(3):57-60.
[3] 邹莉萍,陈蕾,李秀. 肾上腺结核合并艾迪森病1例[J]. 临床肺科杂志, 2015, 20(2):386. DOI: 10.3969/cma.j.issn.1009-6663.2015.01.071.
[4] 单鹏飞,张强,刘玲,等.继发于艾滋病的原发性肾上腺皮质功能减退症一例[J].中华内科杂志, 2012, 51(6):481-482.DOI:10.3760/cma.j.issn.0578-1426.2012.06.024.
[5] 李延兵,江峰,胡国亮,等.慢性肾上腺皮质功能减退症70例临床分析[J].新医学,2001,32(4):207-209。
[6] 任小波,裴爱国,孙革利,等.Addison/病的CT诊断与分型[J].临床放射学杂志,1998,17(2):92-95。
[7] 刘娟,冯小峰,刘秋月,等.肾上腺结核合并Addison's病42例临床分析[J].中国防痨杂志,2005,27(2):101-103.
[8] 赵辨.中国临床皮肤病学[M].1版.南京:江苏科学技术出版社,2010:1341-1342,1254。
[9] 曾令济,陈忠业,范雯雯.进行性肢端黑变病[J].中华皮肤科杂志,2015,48(8):588.DOI:10.3760/cma.j.issn.0412-4030.2015.08.021.
[10] Abdelmotleb M. The Neuropsychiatric Aspect of Addison’s Disease: A Case Report [J]. Innov Clin Neurosci, 2012, 9(10):34-36.
[11] 王倩倩,韩燕燕,孙影辉,等.艾迪生病合并心肌病1例报告[J].临床儿科杂志, 2012, 30(11):1081-1083.DOI:10.3969/cma.j.issn.1000-3606.2012.10.024。
[12] Salhi H. Acute renal failure: a rare presentation of Addison's disease [J]. Pan African Medical Journal, 2016, 24:233.
[13] 孙红兵,魏孔发,庞华.艾迪生病患者猝死的死因分析1例[J].法医学杂志,2007,23(3):222-223。
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    Lingji Zeng, Zhongye Chen. (2019). A Case of Addison's Disease with Only Progressive Skin Pigmentation. Asia-Pacific Journal of Medicine, 1(1), 10-13.

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  • @article{10033497,
      author = {Lingji Zeng and Zhongye Chen},
      title = {A Case of Addison's Disease with Only Progressive Skin Pigmentation},
      journal = {Asia-Pacific Journal of Medicine},
      volume = {1},
      number = {1},
      pages = {10-13},
      url = {https://www.sciencepublishinggroup.com/article/10033497},
      abstract = {A 47 years old woman presented with darkening skins on exposed and frictional areas for more than one year, in addition to fatigue, loss of appetite and weight loss for 2 months. One year ago, there was no inducement of pigmentation on the back of the hand, and it spread to the elbow. Then, the skin of the chest, lower limbs, abdomen, neck, forehead, and internal eyelids also gradually appeared diffuse dark spots. Meanwhile she had low 24-hour urinary excretion of 17-hydroxy steroid and increased ACTH. X-ray test showed point-like calcification shadow on bilateral lungs; CT test showed increased adrenal gland volume, substantially uninformed density, and multiple stippled calcification. Histopathological results: Chromatophilic cells and macrophages that were arranged in nests, scattered and pigment-laden can see subepidermally. Diagnosis: Addison’s disease. After 6 months anti-TB and glucocorticoid hormone replacement therapy, the patient had a good general condition, disappeared clinical symptoms as well as laboratory and imaging test results returned to normal. Now no drugs have been administrated except for 2.5mg of prednisone tablets to take at a draught every morning. The patient is still traced and observed. The study in this case suggests that clinicians should be highly vigilant against Addison's disease in patients who are treated with multiple skin progressive pigmentation.},
     year = {2019}
    }
    

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  • TY  - JOUR
    T1  - A Case of Addison's Disease with Only Progressive Skin Pigmentation
    AU  - Lingji Zeng
    AU  - Zhongye Chen
    Y1  - 2019/01/04
    PY  - 2019
    T2  - Asia-Pacific Journal of Medicine
    JF  - Asia-Pacific Journal of Medicine
    JO  - Asia-Pacific Journal of Medicine
    SP  - 10
    EP  - 13
    PB  - Science Publishing Group
    UR  - http://www.sciencepg.com/article/10033497
    AB  - A 47 years old woman presented with darkening skins on exposed and frictional areas for more than one year, in addition to fatigue, loss of appetite and weight loss for 2 months. One year ago, there was no inducement of pigmentation on the back of the hand, and it spread to the elbow. Then, the skin of the chest, lower limbs, abdomen, neck, forehead, and internal eyelids also gradually appeared diffuse dark spots. Meanwhile she had low 24-hour urinary excretion of 17-hydroxy steroid and increased ACTH. X-ray test showed point-like calcification shadow on bilateral lungs; CT test showed increased adrenal gland volume, substantially uninformed density, and multiple stippled calcification. Histopathological results: Chromatophilic cells and macrophages that were arranged in nests, scattered and pigment-laden can see subepidermally. Diagnosis: Addison’s disease. After 6 months anti-TB and glucocorticoid hormone replacement therapy, the patient had a good general condition, disappeared clinical symptoms as well as laboratory and imaging test results returned to normal. Now no drugs have been administrated except for 2.5mg of prednisone tablets to take at a draught every morning. The patient is still traced and observed. The study in this case suggests that clinicians should be highly vigilant against Addison's disease in patients who are treated with multiple skin progressive pigmentation.
    VL  - 1
    IS  - 1
    ER  - 

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Author Information
  • Departmengt of Dermatology, Jinshazhou Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China

  • Departmengt of Dermatology, Jinshazhou Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China

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