亚厘米级单侧肾上腺腺瘤所致原发性醛固酮增多症

A. Manov, Academic Hospitalist, Tcu Endocrinologist, Amanpreet Kaur
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引用次数: 0

摘要

我们描述了一名44岁的男性,既往有顽固性高血压病史,服用包括利尿剂在内的4种抗高血压药物。尽管他有10年的高血压和低正常钾水平,但他没有被调查高血压的继发性原因。我们开始研究他HTN的继发性原因,并通过评估醛固酮来证实。血浆肾素活性比大于20伴血中醛固酮升高,钠负荷抑制试验提示原发性高醛固酮血症的存在。经腹部CT及MRI检查及肾上腺静脉取样后发现病因为右肾上腺高分泌性腺瘤。我们转介病人进行手术,并开始用矿皮质激素拮抗剂治疗病人,血压有所改善。讨论了目前关于原发性高醛固酮增多症筛查和诊断的建议,以及高醛固酮增多症引起的HTN的有害作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Primary Aldosteronism due to a Sub Centimeter Unilateral Adrenal Adenoma
We have described a 44-year old man with past medical history of resistant hypertension on 4-antihypertensive medications including diuretic. He has not been investigated for secondary causes of hypertension despite having elevated blood pressure for 10-years and low normal Potassium level. We started the work up for secondary causes of his HTN and proved by assessing the aldosterone. To plasma renin activity ratio of more than 20 with elevate aldosterone in the blood, sodium load suppression test the existence of primary hyperaldosteronism. The cause as per the CT and MRI of the abdomen and following adrenalvein sampling was found to be right adrenal gland hypersecreting adenoma. We referred the patient for surgery and started treating the patient with mineralocorticoid antagonist with improvement of the blood pressure. Current recommendation about screening and diagnosing primary hyperaldosteronism were discussed as well as the deleterious effect of HTN due to hyperaldosteronism.
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