地塞米松长期改善的醛固酮瘤

Aldosterone-producing adenoma with prolonged amelioration by dexamethasone.

作者信息

Gomi Y, Taniyama M, Ban Y, Takahashi R, Suzuki S, Murai M

机构信息

Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan

出版信息

Endocr J. 2001 Jun;48(3):331-6. doi: 10.1507/endocrj.48.331.

DOI:10.1507/endocrj.48.331

PMID:11523904

Abstract

Secretion of aldosterone from aldosterone-producing adenoma (APA) is to some degree under the control of ACTH and the suppressible effect of glucocorticoid on plasma aldosterone concentration (PAC) and blood pressure has been reported to be transient. We report a rare case of aldosteronism due to APA in which PAC and blood pressure were well controlled with small dose dexamethasone for over one year. No chimeric gene of glucocorticoid-remediable aldosteronism (GRA) was found in DNA of APA and leukocytes from peripheral blood and 17alpha-hydroxylase deficiency (17-OH-D) was ruled out by endocrinological examinations, this case indicates the possibility of an unknown mechanism of ACTH-dependent APA.

摘要

醛固酮瘤（APA）分泌醛固酮在一定程度上受促肾上腺皮质激素（ACTH）控制，且有报道称糖皮质激素对血浆醛固酮浓度（PAC）和血压的抑制作用是短暂的。我们报告了1例罕见的由APA引起的醛固酮增多症病例，该患者使用小剂量地塞米松使PAC和血压得到良好控制达1年以上。在APA的DNA以及外周血白细胞中未发现糖皮质激素可纠正性醛固酮增多症（GRA）的嵌合基因，并且通过内分泌检查排除了17α-羟化酶缺乏症（17-OH-D），该病例提示存在ACTH依赖性APA的未知机制的可能性。