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[原发性甲状旁腺功能亢进症手术治疗后患者的原发性醛固酮增多症]

[Primary aldosteronism in a patient after surgical treatment of primary hyperparathyroidism].

作者信息

Krysiak Robert, Kobielusz-Gembala Iwona, Okopień Bogusław

机构信息

Klinika Chorób Wewnetrznych i Farmakologii, Klinicznej Katedry Farmakologii, Slaskiego Uniwersytetu Medycznego w Katowicach.

出版信息

Przegl Lek. 2011;68(7):388-90.

Abstract

The presence of both parathyroid adenoma and primary aldosteronism in the same person has been reported in only few patients. Taking into account a relatively high prevalence of both primary hyperparathyroidism and primary aldosteronism in the general population, these findings may be explained by a simple coincidence of both these disorders. In the present paper, we report a man with a family history of multiple endocrine neoplasia type 1 (MEN-1), who developed primary aldosteronism eight years after removal of parathyroid adenoma. We report in details diagnostic and treatment strategies applied in our patient and their impact on the course and outcome of both these disorders. In our opinion, the described case of our patient represents an atypical presentation of MEN-1 syndrome, a hereditary syndrome characterized by a variety of endocrine neoplasias and hormone excess syndromes, particularly tumors of the parathyroid glands, pancreatic islet cells, and pituitary gland. We conclude that each person with MEN-1 syndrome and the presence of adrenal lesions should be assessed for the presence of excess mineralocorticoid activity.

摘要

同一人同时患有甲状旁腺腺瘤和原发性醛固酮增多症的情况仅在少数患者中被报道过。考虑到原发性甲状旁腺功能亢进症和原发性醛固酮增多症在普通人群中的患病率相对较高,这些发现可能仅仅是这两种疾病的巧合。在本文中,我们报告了一名有1型多发性内分泌肿瘤(MEN-1)家族史的男性,他在甲状旁腺腺瘤切除术后八年患上了原发性醛固酮增多症。我们详细报告了应用于我们患者的诊断和治疗策略以及它们对这两种疾病的病程和结局的影响。我们认为,我们患者的所述病例代表了MEN-1综合征的非典型表现,MEN-1综合征是一种遗传性综合征,其特征是多种内分泌肿瘤和激素过多综合征,特别是甲状旁腺、胰岛细胞和垂体的肿瘤。我们得出结论,每个患有MEN-1综合征且有肾上腺病变的人都应评估是否存在盐皮质激素活性过高的情况。

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