Ohta Yuko, Ueno Michio, Kajioka Tomoko, Tominaga Mitsuhiro, Odakura Takashi, Tsuchihashi Takuya
Department of Internal Medicine, National Kyushu Medical Center Hospital.
Nihon Jinzo Gakkai Shi. 2002 Dec;44(8):813-6.
We report here a unique case of recurrent malignant hypertension after the removal of an adrenal tumor for primary aldosteronism. The patient had a history of hypertension for 15 years. In 1995, he developed drug-resistant hypertension with hyperreninemia, hyperaldosteronemia and hypokalemia. He was diagnosed as having primary aldosteronism with a right adrenal tumor. His blood pressure did not normalize and renal dysfunction continued after the adrenalectomy. Although antihypertensive treatment was continued for residual hypertension, he soon refused medication. In 1997, he developed recurrent malignant hypertension. It was considered that the different underlying mechanisms might be attributable to the two episodes of malignant hypertension in this patient.
我们在此报告一例独特的病例，该患者因原发性醛固酮增多症切除肾上腺肿瘤后出现复发性恶性高血压。患者有15年高血压病史。1995年，他出现耐药性高血压，伴有高肾素血症、高醛固酮血症和低钾血症。他被诊断为原发性醛固酮增多症伴右侧肾上腺肿瘤。肾上腺切除术后，他的血压未恢复正常，肾功能障碍仍持续存在。尽管针对残余高血压继续进行了降压治疗，但他很快就拒绝服药。1997年，他出现复发性恶性高血压。据认为，该患者两次恶性高血压发作可能归因于不同的潜在机制。
