@article{oai:kanazawa-u.repo.nii.ac.jp:00013246,
 author = {西澤, 依小 and 笠原, 寿郎 and 明, さおり and 木部, 佳紀 and 安井, 正英 and 藤村, 政樹 and 中尾, 眞二},
 issue = {6},
 journal = {Japanese Journal of Lung Cancer = 肺癌},
 month = {Oct},
 note = {Case : A 52-year-old man, who had undergone lobectomy and left adrenalectomy two years prenously because of lung adenocarcinoma with left isolated adrenal metastasis, was admitted with general malaise and nausea after upper respiratory tract infection. He had skin and mucosal pigmentation, and the laboratory data showed hyponatremia and hyperkalemia. Abdominal CT showed a grossly enlarged residual right adrenal gland. Serum ACTH level was high, cortisol and aldosterone levels were low, and their circadian rhythms were absent. He had no response to rapid ACTH stimulation and thus we diagnosed Addison's disease due to bilateral adrenal metastases of the lung adenocarcinoma. Hydrocortisone replacement therapy resulted in rapid improvement of his general condition an laboratory data. Conclusion : Although metastases to the adrenal glands are common in patients with lung cancer, Addison's disease has been rarely noted. Since adrenal insufficiency may develop abruptly, it is important to examine physical findings and past history. Furthermore, adrenal function tests and diagnostic imaging should e done in these cases. 症例は52歳, 男性, 肺腺癌およびその左副腎転移に対する摘出手術を受け, その約2年後に上気道感染後の強い倦怠感と消化器症状を訴えて受診した.皮膚・粘膜の色素沈着, 低Na血症・高K血症を認め, 画像所見上, 残存側である右副腎にも新たに転移巣と思われる陰影が認められた.ACTHは高値で, コルチゾールとアルドステロンは低値で日内変動が認められず, rapid ACTH試験においても無反応であったことより, 肺癌の両側副腎転移によりAddison病を呈したと考えられた.Hydrocortisoneの投与により, 自・他覚症状はすみやかに改善した.肺癌の副腎転移にてAddison病を呈した報告は稀であるが, 急速に副腎不全状態に陥ることもあり, このような症例においては身体所見や病歴を見過ごすことなく, 積極的に内分泌検査や画像検査を行うことが重要であると考えられた., 金沢大学医薬保健研究域医学系},
 pages = {623--627},
 title = {両側副腎転移によりAddison病を呈した肺腺癌の1例},
 volume = {40},
 year = {2000}
}