zdorПроблемы здоровья и экологииHealth and Ecology Issues2220-09672708-6011Gomel State Medical University10.51523/2708-6011.2025-22-4-17zdor-2897Research ArticleСЛУЧАЙ ИЗ КЛИНИЧЕСКОЙ ПРАКТИКИCLINICAL CASESКлинический случай первичной хронической недостаточности коры надпочечников (болезнь Аддисона)Clinical case of primary chronic adrenal cortex insufficiency (Addison’s disease)https://orcid.org/0000-0002-6273-7222ПроневичА. В.PronevichA. V.

Проневич Анна Васильевна - старший преподаватель кафедры поликлинической терапии и общеврачебной практики с курсом ФПКиП.

Гомель

Anna V. Pronevich - Senior Lecturer at the Department of Outpatient Therapy and General Medical Practice with the course of Advanced Training and Retraining, Gomel State Medical University.

Gomel

busel1984@mail.ruhttps://orcid.org/0000-0002-6123-2919НикифороваО. Л.NikiforovaO. L.

Никифорова Ольга Леонидовна - старший преподаватель кафедры поликлинической терапии и общеврачебной практики с курсом ФПКиП.

Гомель

Olga L. Nikiforova - Senior Lecturer at the Department of Outpatient Therapy and General Medical Practice with the course of Advanced Training and Retraining, Gomel State Medical University.

Gomel

Nikiforova.O.L@yandex.ruГомельский государственный медицинский университетGomel State Medical University202521012026224135140Copyright © Проневич А.В., Никифорова О.Л., 20262026Проневич А.В., Никифорова О.Л.Pronevich A.V., Nikiforova O.L.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.gsmu.by/jour/article/view/2897

Надпочечниковая недостаточность является относительно редким, но серьезным заболеванием, характеризующимся снижением продукции глюкокортикоидов и/или минералокортикоидов и надпочечниковых андрогенов из-за разрушения надпочечника или отсутствия его стимуляции. Это состояние проявляется едва заметными и довольно неспецифическими признаками и симптомами, которые развиваются в течение недель и месяцев и часто остаются незамеченными, что приводит к задержке в диагностике [1]. Для постановки диагноза требуется высокий уровень клинической настороженности и знаний диагностики.

В статье представлен клинический случай первичной хронической недостаточности коры надпочечников (НКН) у пациента среднего возраста. Проведен анализ литературных источников, клинических данных, результатов лабораторных исследований.

Adrenal insufficiency is a relatively rare but serious disease characterized by decreased production of glucocorticoids and/or mineralocorticoids and adrenal androgens due to adrenal destruction or lack of its stimulation. This condition is characterized with subtle and rather nonspecific signs and symptoms that develop over weeks to months, and often go unnoticed, leading to delays in diagnosis [1]. A high level of clinical suspicion and diagnostic knowledge are required for diagnosis.

The article presents a clinical case of primary chronic adrenal cortex insufficiency in a middle-aged patient. An analysis of literary sources, clinical data, and laboratory test results was performed.

первичная хроническая недостаточность коры надпочечниковболезнь Аддисонаклинический случайprimary chronic adrenal cortex insufficiencyAddison’s diseaseclinical caseReferencesKumar R, Wassif WS. Adrenal insufficiency. J Clin Pathol. 2022 Jul;75(7):435-442. DOI: https://doi.org/10.1136/jclinpath-2021-207895Kumar R, Wassif WS. Adrenal insufficiency. J Clin Pathol. 2022 Jul;75(7):435-442. DOI: https://doi.org/10.1136/jclinpath-2021-207895Lewis A, Thant AA, Aslam A, Aung PPM, Azmi S. Diagnosis and management of adrenal insufficiency. Clin Med (Lond). 2023;23(2):115-118. DOI: https://doi.org/10.7861/clinmed.2023-0067Lewis A, Thant AA, Aslam A, Aung PPM, Azmi S. Diagnosis and management of adrenal insufficiency. Clin Med (Lond). 2023;23(2):115-118. DOI: https://doi.org/10.7861/clinmed.2023-0067Huecker MR, Bhutta BS, Dominique E. Adrenal Insufficiency. In: StatPearls. Treasure Island (FL): StatPearls Publishing; August 17, 2023. [date of access 2025 July 05]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441832/Huecker MR, Bhutta BS, Dominique E. Adrenal Insufficiency. In: StatPearls. Treasure Island (FL): StatPearls Publishing; August 17, 2023. [date of access 2025 July 05]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441832/Bathla JS, Chitale A, Shahzad S, Elbathani M, Sarvadevabatla N. Too Dry for Primary Adrenal Insufficiency (PAI): PAI Masked by Volume Depletion. Cureus. 2024;16(5):e61018. DOI: https://doi.org/10.7759/cureus.61018Bathla JS, Chitale A, Shahzad S, Elbathani M, Sarvadevabatla N. Too Dry for Primary Adrenal Insufficiency (PAI): PAI Masked by Volume Depletion. Cureus. 2024;16(5):e61018. DOI: https://doi.org/10.7759/cureus.61018Quénéhervé L, Drui D, Blin J, Péré M, Coron E, Barbara G, Barbaro MR, Cariou B, Neunlist M, Masson D, Bach-Ngohou K. Digestive symptoms in daily life of chronic adrenal insufficiency patients are similar to irritable bowel syndrome symptoms. Sci Rep. 2021 Apr 13;11(1):8077. DOI: https://doi.org/10.1038/s41598-021-87158-2Quénéhervé L, Drui D, Blin J, Péré M, Coron E, Barbara G, Barbaro MR, Cariou B, Neunlist M, Masson D, Bach-Ngohou K. Digestive symptoms in daily life of chronic adrenal insufficiency patients are similar to irritable bowel syndrome symptoms. Sci Rep. 2021 Apr 13;11(1):8077. DOI: https://doi.org/10.1038/s41598-021-87158-2Pelewicz K, Miśkiewicz P. Glucocorticoid Withdrawal-An Overview on When and How to Diagnose Adrenal Insufficiency in Clinical Practice. Diagnostics (Basel). 2021 Apr 20;11(4):728. DOI: https://doi.org/10.3390/diagnostics11040728Pelewicz K, Miśkiewicz P. Glucocorticoid Withdrawal-An Overview on When and How to Diagnose Adrenal Insufficiency in Clinical Practice. Diagnostics (Basel). 2021 Apr 20;11(4):728. DOI: https://doi.org/10.3390/diagnostics11040728Quénéhervé L, Drui D, Blin J, Péré M, Coron E, Barbara G, Barbaro MR, Cariou B, Neunlist M, Masson D, Bach-Ngohou K. Digestive symptoms in daily life of chronic adrenal insufficiency patients are similar to irritable bowel syndrome symptoms. Sci Rep. 2021 Apr 13;11(1):8077.Quénéhervé L, Drui D, Blin J, Péré M, Coron E, Barbara G, Barbaro MR, Cariou B, Neunlist M, Masson D, Bach-Ngohou K. Digestive symptoms in daily life of chronic adrenal insufficiency patients are similar to irritable bowel syndrome symptoms. Sci Rep. 2021 Apr 13;11(1):8077.Munir S, Quintanilla Rodriguez BS, Waseem M. Addison Disease. In: StatPearls. Treasure Island (FL): StatPearls Publishing; January 30, 2024. [date of access 2025 July 01]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441994/Munir S, Quintanilla Rodriguez BS, Waseem M. Addison Disease. In: StatPearls. Treasure Island (FL): StatPearls Publishing; January 30, 2024. [date of access 2025 July 01]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441994/Vance SJ, Horsley JT, Welch MP, Muterspaugh RD, Pandey J. Educational Case: Adrenocortical insufficiency-Causes and pathogenesis. Acad Pathol. 2022 May 17;9(1):100019. DOI: https://doi.org/10.1016/j.acpath.2022.100019Vance SJ, Horsley JT, Welch MP, Muterspaugh RD, Pandey J. Educational Case: Adrenocortical insufficiency-Causes and pathogenesis. Acad Pathol. 2022 May 17;9(1):100019. DOI: https://doi.org/10.1016/j.acpath.2022.100019Pazderska A, Pearce SH. Adrenal insufficiency - recognition and management. Clin Med (Lond). 2017;17(3):258-262. DOI: https://doi.org/10.7861/clinmedicine.17-3-258Pazderska A, Pearce SH. Adrenal insufficiency - recognition and management. Clin Med (Lond). 2017;17(3):258-262. DOI: https://doi.org/10.7861/clinmedicine.17-3-258Yamamoto T. Latent Adrenal Insufficiency: Concept, Clues to Detection, and Diagnosis. Endocr Pract. 2018;24(8):746-755. DOI: https://doi.org/10.4158/EP-2018-0114Yamamoto T. Latent Adrenal Insufficiency: Concept, Clues to Detection, and Diagnosis. Endocr Pract. 2018;24(8):746-755. DOI: https://doi.org/10.4158/EP-2018-0114Wäscher H, Knauerhase A, Klar B, Postrach T, Weber MA, Willenberg HS. On Primary Adrenal Insufficiency with Normal Concentrations of Cortisol - Early Manifestation of Addison’s Disease. Horm Metab Res. 2024;56(1):16-19. DOI: https://doi.org/10.1055/a-2180-7108Wäscher H, Knauerhase A, Klar B, Postrach T, Weber MA, Willenberg HS. On Primary Adrenal Insufficiency with Normal Concentrations of Cortisol - Early Manifestation of Addison’s Disease. Horm Metab Res. 2024;56(1):16-19. DOI: https://doi.org/10.1055/a-2180-7108Husebye ES, Allolio B, Arlt W, et al. Consensus statement on the diagnosis, treatment and follow-up of patients with primary adrenal insufficiency. J Intern Med. 2014;275(2):104-115. DOI: https://doi.org/10.1111/joim.12162Husebye ES, Allolio B, Arlt W, et al. Consensus statement on the diagnosis, treatment and follow-up of patients with primary adrenal insufficiency. J Intern Med. 2014;275(2):104-115. DOI: https://doi.org/10.1111/joim.12162Alorni A, Minarelli V, Morelli S. Therapy of adrenal insufficiency: an update. Endocrine. 2013;43(3):514-528. DOI: https://doi.org/10.1007/s12020-012-9835-4Alorni A, Minarelli V, Morelli S. Therapy of adrenal insufficiency: an update. Endocrine. 2013;43(3):514-528. DOI: https://doi.org/10.1007/s12020-012-9835-4

The authors declare that there are no conflicts of interest present.