Burns A P, O'Connell P R, Murnaghan D J, Brady M P
Department of Medicine, Regional Hospital, Cork, Ireland.
Postgrad Med J. 1989 Dec;65(770):943-7. doi: 10.1136/pgmj.65.770.943.
A 21 year old male was discovered to be severely hypertensive. He was found to have bilateral adrenal phaeochromocytomas and a single renal artery stenosis. More than 40 cases of coexisting renal artery stenosis and phaeochromocytomas have been reported. The aetiology of renal artery stenosis in association with phaeochromocytoma maybe multifactorial and the radiographic appearances are not always clear-cut. Renin levels in this patient were elevated prior to the removal of the phaeochromocytomas but the renal vein renin ratio did not suggest that the renal artery stenosis contributed significantly to his hypertension. The patient's hypertension resolved following successful removal of the phaeochromocytomas despite persistence of the renal artery stenosis. Thus, though renin levels may be misleading in these cases, renal vein renin ratios may still be helpful in deciding on patient management.
一名21岁男性被发现患有严重高血压。他被查出双侧肾上腺嗜铬细胞瘤和单一肾动脉狭窄。已有超过40例肾动脉狭窄与嗜铬细胞瘤并存的病例报告。肾动脉狭窄与嗜铬细胞瘤相关的病因可能是多因素的，影像学表现并不总是清晰明确。该患者在切除嗜铬细胞瘤之前肾素水平升高，但肾静脉肾素比值并不表明肾动脉狭窄对其高血压有显著影响。尽管肾动脉狭窄持续存在，但成功切除嗜铬细胞瘤后患者的高血压得到缓解。因此，尽管在这些病例中肾素水平可能会产生误导，但肾静脉肾素比值在决定患者治疗方案时可能仍然有用。
