Pemayun Tjokorda Gde Dalem, Naibaho Ridho, Wiyati Maretina W, Santosa Ardy, Amarwati Siti
Department of Internal Medicine Faculty of Medicine, Diponegoro University - Dr. Kariadi Hospital Semarang, Indonesia.
Acta Med Indones. 2017 Jul;49(3):249-254.
Primary hyperaldosteronism is an adrenal abnormality in which there is some degree of autonomy of aldosterone secretion. We report a case of thirty three years old Javanese female presented with uncontrolled hypertension, muscular weakness, cramps and progressing shortness of breath during working for 6 years. She had history of hypertension since age 20. Her serum potassium level was always low that associated with inappropriate kaliuresis. Blood gas analysis revealed metabolic alkalosis. Sonography of the adrenal gland showed right hipoechoic architecture; CT scan of the abdomen confirmed an right adrenal tumor measured 4 cm in its greatest dimension. Endocrine evaluation revealed high plasma aldosterone concentration, suppressed plasma renin activity, aldosterone/renin ratio of 112 and confirmed the diagnosis of primary aldosteronism. She underwent unilateral adrenalectomy. Histopathological report from excised adrenal tumor were compatible to benign adrenocortical adenoma. The patient discharge home with well controlled blood pressure and normokalemia. No clinical symptoms was reported in follow-up.
原发性醛固酮增多症是一种肾上腺异常疾病,其醛固酮分泌存在一定程度的自主性。我们报告一例33岁的爪哇女性患者,她在工作6年期间出现血压控制不佳、肌肉无力、痉挛以及进行性呼吸困难。她自20岁起就有高血压病史。她的血清钾水平一直很低,并伴有不适当的尿钾增多。血气分析显示代谢性碱中毒。肾上腺超声检查显示右侧低回声结构;腹部CT扫描证实右侧肾上腺有一个最大直径为4厘米的肿瘤。内分泌评估显示血浆醛固酮浓度升高、血浆肾素活性受抑制、醛固酮/肾素比值为112,从而确诊为原发性醛固酮增多症。她接受了单侧肾上腺切除术。切除的肾上腺肿瘤的组织病理学报告与良性肾上腺皮质腺瘤相符。患者出院时血压得到良好控制,血钾正常。随访中未报告临床症状。