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醛固酮瘤所致原发性醛固酮增多症:病因诊断中的问题

[Primary aldosteronism caused by aldosteronoma: problems in the etiologic diagnosis].

作者信息

Danilovic Debora Lucia S, Freire Daniel Soares, Paraíba Diane Belchior, Brandão Neto Rodrigo A, Lucon Antônio Marmo, Pereira Maria Adelaide A

机构信息

Serviço de Endocrinologia e Metabologia, Hospital das Clínicas, Faculdade de Medicina, USP, São Paulo, SP.

出版信息

Arq Bras Endocrinol Metabol. 2007 Apr;51(3):478-87. doi: 10.1590/s0004-27302007000300018.

Abstract

Primary aldosteronism (PA) represents an important cause of secondary hypertension, potentially curable, and it has been receiving particular attention due to its increasing prevalence, after the beginning of the use of plasma aldosterone concentration to plasma renin activity ratio as a screening method. We present a case of PA caused by an aldosteronoma associated with a contralateral nonfunctioning adrenal adenoma, which resulted in difficulties in the final diagnosis. We discuss the most appropriated tests to screen, confirm the diagnosis of PA and define the etiology of the disorder, especially the adrenal veins sampling to distinguish the aldosteronoma and idiopathic hyperaldosteronism and to guide successful treatment.

摘要

原发性醛固酮增多症(PA)是继发性高血压的一个重要病因,有可能治愈。自从开始使用血浆醛固酮浓度与血浆肾素活性比值作为筛查方法以来,由于其患病率不断上升,PA受到了特别关注。我们报告一例由醛固酮瘤合并对侧无功能肾上腺腺瘤引起的PA病例,该病例导致最终诊断困难。我们讨论了用于筛查、确诊PA以及明确该疾病病因的最合适检查,尤其是肾上腺静脉采血,以区分醛固酮瘤和特发性醛固酮增多症并指导成功治疗。

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