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与难治性高血压相关的纯分泌雄激素的肾上腺腺瘤

Pure androgen-secreting adrenal adenoma associated with resistant hypertension.

作者信息

Rodríguez-Gutiérrez René, Bautista-Medina Mario Arturo, Teniente-Sanchez Ana Eugenia, Zapata-Rivera Maria Azucena, Montes-Villarreal Juan

机构信息

Endocrinology Division, University Hospital "Dr. José E. González," Universidad Autonoma de Nuevo León, 64460 Monterrey, NL, Mexico.

出版信息

Case Rep Endocrinol. 2013;2013:356086. doi: 10.1155/2013/356086. Epub 2013 May 29.

DOI:10.1155/2013/356086
PMID:23819074
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3681270/
Abstract

Pure androgen-secreting adrenal adenoma is very rare, and its diagnosis remains a clinical challenge. Its association with resistant hypertension is uncommon and not well understood. We present an 18-year-old female with a 10-year history of hirsutism that was accidentally diagnosed with an adrenal mass during the evaluation of a hypertensive crisis. She had a long-standing history of hirsutism, clitorimegaly, deepening of the voice, and primary amenorrhea. She was phenotypically and socially a male. FSH, LH, prolactin, estradiol, 17-hydroxyprogesterone, and progesterone were normal. Total testosterone and DHEA-S were elevated. Cushing syndrome, primary aldosteronism, pheochromocytoma, and nonclassic congenital adrenal hyperplasia were ruled out. She underwent adrenalectomy and pathology reported an adenoma. At 2-month followup, hirsutism and virilizing symptoms clearly improved and blood pressure normalized without antihypertensive medications, current literature of this unusual illness and it association with hypertension is presented and discussed.

摘要

纯分泌雄激素的肾上腺腺瘤非常罕见，其诊断仍然是一项临床挑战。它与难治性高血压的关联并不常见，且尚未得到充分了解。我们报告一名18岁女性，有10年多毛症病史，在评估高血压危象期间意外诊断出肾上腺肿块。她有长期多毛症、阴蒂肥大、声音低沉和原发性闭经病史。她在表型和社交方面均为男性。促卵泡生成素、促黄体生成素、催乳素、雌二醇、17-羟孕酮和孕酮均正常。总睾酮和硫酸脱氢表雄酮水平升高。库欣综合征、原发性醛固酮增多症、嗜铬细胞瘤和非经典先天性肾上腺皮质增生均被排除。她接受了肾上腺切除术，病理报告为腺瘤。在2个月的随访中，多毛症和男性化症状明显改善，血压在未服用抗高血压药物的情况下恢复正常，本文展示并讨论了关于这种罕见疾病及其与高血压关联的现有文献。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa20/3681270/5457e7e5d95a/CRIM.ENDOCRINOLOGY2013-356086.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa20/3681270/9c462a8a1234/CRIM.ENDOCRINOLOGY2013-356086.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa20/3681270/bf8a181a8aa9/CRIM.ENDOCRINOLOGY2013-356086.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa20/3681270/07aa2a2fa65e/CRIM.ENDOCRINOLOGY2013-356086.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa20/3681270/5457e7e5d95a/CRIM.ENDOCRINOLOGY2013-356086.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa20/3681270/9c462a8a1234/CRIM.ENDOCRINOLOGY2013-356086.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa20/3681270/bf8a181a8aa9/CRIM.ENDOCRINOLOGY2013-356086.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa20/3681270/07aa2a2fa65e/CRIM.ENDOCRINOLOGY2013-356086.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa20/3681270/5457e7e5d95a/CRIM.ENDOCRINOLOGY2013-356086.004.jpg

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