Eguchi Kazuo, Hoshide Satoshi, Nagashima Shuichi, Maekawa Takashi, Sasano Hironobu, Kario Kazuomi
Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University, Japan.
Intern Med. 2014;53(21):2499-504. doi: 10.2169/internalmedicine.53.2762. Epub 2014 Nov 1.
A 31-year-old woman with treatment-resistant pregnancy-induced hypertension during her first pregnancy delivered a small-for-gestational-age infant (weight: 1,070 g). After delivery, she was diagnosed with primary aldosteronism (PA) associated with a left adrenal adenoma. Following a thorough examination, she underwent laparoscopic left adrenalectomy, and the diagnosis of an aldosterone-producing adenoma was confirmed based on a pathological examination. Thereafter, the patient's hypertension and hypokalemia completely disappeared. She became pregnant again and successfully delivered her second infant at the 37th week of gestation (weight: 2,720 g) without developing treatment-resistant hypertension. Secondary causes of hypertension should not be overlooked, even in young pregnant women.
一名31岁女性在首次怀孕时患有难治性妊娠高血压,分娩出一名小于胎龄儿(体重:1070克)。产后,她被诊断为原发性醛固酮增多症(PA),伴有左肾上腺腺瘤。经过全面检查后,她接受了腹腔镜下左肾上腺切除术,病理检查证实为醛固酮分泌性腺瘤。此后,患者的高血压和低钾血症完全消失。她再次怀孕,并在妊娠第37周成功分娩出第二个婴儿(体重:2720克),未出现难治性高血压。即使在年轻孕妇中,高血压的继发性病因也不应被忽视。