Patienten mit Nebenniereninsuffizienz (NNI) haben neben einer verminderten Lebensqualität
auch eine erhöhte Mortalität, insbesondere durch Nebennierenkrisen. Letztere könnten
durch zeitgerechte parenterale Glukokortikoidgaben verhindert werden. Checkpoint-Inhibitoren
gewinnen als Ursache einer NNI zunehmend an Bedeutung. Nach wie vor stellen NNI und
Nebennierenkrisen eine große Herausforderung für Patienten, Angehörige und behandelnde
Ärzte dar.
Abstract
According to long-term studies, patients with adrenal insufficiency (AI) exhibit a
reduced quality of life and increased mortality. In addition to cardiovascular and
malignant diseases, the risk of mortality is particularly increased by adrenal crises.
Fatal adrenal crises could be completely prevented by timely intravenous or subcutaneous
administration of glucocorticoids. In the case of an established diagnosis of AI,
a deterioration in the general condition, gastroenteritis symptoms, exsiccosis and
a clinical picture of sepsis must lead to the suspicion of an adrenal crisis. However,
the diagnosis is only confirmed by the response to glucocorticoids. So-called check-point
inhibitors are becoming increasingly important as a cause of AI. Therefore, AI and
adrenal crises continue to pose a challenge for patients, their relatives and the
treating physicians.
Schlüsselwörter
Nebenniereninsuffizienz - Morbus Addison - Nebennierenkrise - Immun-Checkpoint-Inhibitoren
- Hypophyseninsuffizienz
Keywords
adrenal insufficiency - Addison disease - adrenal crisis - immune check-point inhibitor
- hypopituitarism
