Steinfurt Johannes, Müller Markus C, Seidel Anke, Salm Richard, Ochs Andreas
Abteilung für Innere Medizin, Loretto-Krankenhaus, Freiburg, Germany.
Med Klin (Munich). 2010 Jul;105(7):496-500. doi: 10.1007/s00063-010-1084-9. Epub 2010 Jul 30.
The authors report on a 51-year-old patient with transient pareses, myalgias, and a massive creatine kinase elevation which had led to an intensive neurological work-up by the general practitioner. Despite refractory hypertension, primary aldosteronism was not excluded. At the authors' clinic, the patient was diagnosed to have Conn's syndrome. Laparoscopic adrenalectomy revealed a big adenoma of the left adrenal gland.
Transient pareses, myalgias, and creatine kinase elevation can indicate primary aldosteronism among hypertensive patients. If clinically suspected, the aldosterone-renin ratio should be determined.
作者报告了一名51岁的患者,该患者出现短暂性轻瘫、肌痛,肌酸激酶大幅升高,全科医生因此对其进行了全面的神经学检查。尽管患者患有难治性高血压,但原发性醛固酮增多症仍未被排除。在作者所在的诊所,该患者被诊断为康恩综合征。腹腔镜肾上腺切除术显示左肾上腺有一个大腺瘤。
短暂性轻瘫、肌痛和肌酸激酶升高可能提示高血压患者存在原发性醛固酮增多症。如果临床怀疑,应测定醛固酮-肾素比值。