原发性醛固酮增多症的血压正常表现:附两例报告。

IF 2.1 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE
Minyue Jia, Hanxiao Yu, Zhenjie Liu, Minzhi He, Shan Zhong, Xiaohong Xu, Xiaoxiao Song
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引用次数: 2

摘要

原发性醛固酮增多症(PA)的正常血压患者相对罕见。在此,我们报告了两例血压正常的PA患者,并进行了文献综述,以提高对该疾病的了解。患者1,56岁男性,复发性低钾血症持续2年多。患者2为33岁男性,表现为性功能障碍,诊断为泌乳素瘤合并肾上腺功能不全和性腺功能减退。这些患者都没有高血压,反复的手工测量可检测到。在这两例患者中,典型的PA生物学特征被证明包括低钾血症伴钾尿症、血浆醛固酮浓度升高(PAC)、血浆肾素浓度抑制以及醛固酮与肾素的高比值。两例患者在生理盐水输注试验中均没有充分抑制PAC,证实了PA的诊断。肾上腺计算机断层扫描和肾上腺静脉取样提示醛固酮瘤,醛固酮侧侧高分泌证实了这一点。良性腺瘤切除后,生化异常得到纠正。由于高血压不一定是PA的标志,我们建议所有低钾血症患者都应筛查PA,以预防心血管并发症,同时平衡经济和有效性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Normotensive presentation in primary aldosteronism: A report of two cases.

Normotensive presentation in primary aldosteronism: A report of two cases.

Normotensive presentation in primary aldosteronism: A report of two cases.

Normotensive presentation in primary aldosteronism: A report of two cases.

Normotensive patients with primary aldosteronism (PA) are relatively rare. Herein, we report two patients with normotensive PA and present a literature review to improve an understanding of the disease. Patient 1, a 56-year-old man, presented with recurrent hypokalemia that lasted for more than 2 years. Patient 2 was a 33-year-old man who presented with sexual dysfunction and was diagnosed with a prolactinoma combined with adrenal insufficiency and hypogonadism. Neither of these patients had hypertension that was detectable on repeated manual measurements. In both patients, a typical biological profile of PA was demonstrated that included hypokalemia with kaliuresis, elevated plasma aldosterone concentration (PAC), suppressed plasma renin concentration, and a high aldosterone-to-renin ratio. Both patients did not have sufficiently suppressed PAC on the saline infusion test, confirming the diagnosis of PA. Computed tomography of the adrenal gland and adrenal venous sampling suggested an aldosteronoma, which was confirmed by lateralized hypersecretion of aldosterone. After removal of the benign adenoma, the biochemical abnormalities were corrected. As hypertension is not necessarily a sign of PA, we propose that all patients with hypokalemia should be screened for PA in order to prevent cardiovascular complications while balancing economics and effectiveness.

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来源期刊
CiteScore
6.20
自引率
0.00%
发文量
16
审稿时长
6-12 weeks
期刊介绍: JRAAS is a peer-reviewed, open access journal, serving as a resource for biomedical professionals, primarily with an active interest in the renin-angiotensin-aldosterone system in humans and other mammals. It publishes original research and reviews on the normal and abnormal function of this system and its pharmacology and therapeutics, mostly in a cardiovascular context but including research in all areas where this system is present, including the brain, lungs and gastro-intestinal tract.
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