酮康唑(ketoconazole)是治疗各种皮肤和全身性霉菌病的药物。业已证明,它可抑制睾丸和肾上腺类固醇的合成。但尚未见到引起明显急性肾上腺危象的报道。本文报告1例Ⅰ型糖尿病及未发现的甲状腺功能减退患者服用大剂量酮康唑后引起急性肾上腺功能不全。患者男性、56岁,有Ⅰ型糖尿病史27年。7年来一直每日注射混合胰岛素57U,近2月来无低血糖症状发作。患者长期有怕冷、便秘及阳萎等症状。因患棘阿米巴性角膜炎,口服酮康唑400mg 每日4次。18天后,尽管胰岛素剂量减少,仍经常出现低血糖症状,以后改为600mg 每日2次口服,持续5天。体 Ketoconazole is a drug used to treat various skin and systemic mycosis. It has been shown that it inhibits testis and adrenal steroid synthesis. However, no reports of a clear acute adrenal crisis have yet been seen. This article reports 1 case of type 1 diabetes and undetected hypothyroidism patients taking large doses of ketoconazole caused by acute adrenal insufficiency. Male patient, 56 years old, has a history of type I diabetes for 27 years. 7 years has been a daily injection of mixed insulin 57U, no hypoglycemia symptoms in the past two months. Patients have long been cold, constipation and impotence and other symptoms. Due to Acanthamoeba meningitis, oral ketoconazole 400mg 4 times daily. After 18 days, the hypoglycemic symptoms often recur despite a decrease in insulin dosage and later changed to 600 mg orally twice daily for 5 days. body