{"created":"2023-06-20T15:50:35.466476+00:00","id":3426,"links":{},"metadata":{"_buckets":{"deposit":"9073f718-cae9-42c4-b09f-2527ca19359b"},"_deposit":{"created_by":18,"id":"3426","owners":[18],"pid":{"revision_id":0,"type":"depid","value":"3426"},"status":"published"},"_oai":{"id":"oai:redcross.repo.nii.ac.jp:00003426","sets":["99:64:118"]},"author_link":["8231","6842","256","380","49","8084","48","8085","129","8112","8232","8109"],"item_5_biblio_info_7":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2005-03-01","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"64","bibliographicPageStart":"60","bibliographicVolumeNumber":"10","bibliographic_titles":[{"bibliographic_title":"徳島赤十字病院医学雑誌"},{"bibliographic_title":"Tokushima Red Cross Hospital Medical Journal","bibliographic_titleLang":"en"}]}]},"item_5_description_5":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"症例は73歳，男性．2003年12月６日より発熱，嘔吐が出現して近医を受診した．輸液にて症状は軽快したが，12月22日より顔面の浮腫が出現し，12月25日には意識障害をきたしたため，近医に入院した．低血圧，低酸素血症，低血糖とともに頭頸部の著明な浮腫がみられたため，上大静脈症候群の疑いで当院に救急搬送された．来院時，顔面・頸部の浮腫，全身倦怠感，視野狭窄があり，入院後，浮腫は徐々に軽減したが，食欲不振・低Na 血症・低血糖は持続した．内分泌検査にて，血漿ACTH＜4.0pg/ml，Cortisol1.4μg/dl，尿中Cortisol4.9μg／日などから続発性副腎不全が疑われ，hydrocortisone の補充により症状は急速に改善した．視床下部ホルモン4者負荷試験ではACTH 以外の下垂体前葉ホルモン分泌は保たれており，ACTH 単独欠損症と診断した．頭部CT・MRI では視床下部・下垂体系に形態的異常はなく，抗下垂体抗体は陰性であった．入院時の血漿ADH 濃度は，低浸透圧にもかかわらず32.0pg/ml と異常高値を示していた．副腎不全やACTH 単独欠損症の主症状として著明な浮腫が記載された報告はほとんどなく，本例に頭頚部\r\nの浮腫が発現した詳細な機序は不明であるが，著明な高ADH 血症による体液貯留が関与した可能性が示唆された．","subitem_description_type":"Abstract"}]},"item_5_full_name_3":{"attribute_name":"著者別名","attribute_value_mlt":[{"nameIdentifiers":[{"nameIdentifierScheme":"WEKO"}],"names":[{"name":"MIKI, 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Edema","subitem_title_language":"en"}]},"item_type_id":"5","owner":"18","path":["118"],"pubdate":{"attribute_name":"公開日","attribute_value":"2013-05-06"},"publish_date":"2013-05-06","publish_status":"0","recid":"3426","relation_version_is_last":true,"title":["頭頚部の浮腫を契機に発見され，高ADH血症を示したACTH単独欠損症の１例"],"weko_creator_id":"18","weko_shared_id":18},"updated":"2023-06-20T22:04:16.835832+00:00"}