一例原发性醛固酮增多症合并继发性甲状旁腺功能亢进及双侧肾上腺肿瘤
A case of primary aldosteronism with secondary hyperparathyroidism and bilateral adrenal tumors.
作者信息
Eguchi Tohru, Miyauchi Shozo
机构信息
Department of Internal Medicine, 1-1 Gotenmachi, Uwajima, Ehime, 798-8510, Japan
出版信息
Endocrinol Diabetes Metab Case Rep. 2015 Jul 1;2015:15-0029. doi: 10.1530/EDM-15-0029.
SUMMARY
A 43-year-old Japanese woman was admitted to our hospital with weakness. Laboratory findings showed hypokalemia, hypocalcemia and elevation of the serum creatinine phosphokinase levels, but intact parathyroid hormone levels. Further evaluations suggested that she had primary aldosteronism (PA), secondary hyperparathyroidism and bilateral adrenal tumors. She was treated successfully by laparoscopic right adrenalectomy. This case not only serves to the diagnosis of bilateral adrenal tumors in which selective adrenal venous sampling (SAVS) proved to be useful, but also for physicians to be aware of secondary hyperparathyroidism and the risk of secondary osteoporosis caused by PA.
LEARNING POINTS
The classic presenting signs of PA are hypertension and hypokalemia. Hypokalemia can induce rhabdomyolysis. PA causes secondary hyperparathyroidism. Patients with PA have the risk of osteoporosis with secondary hyperparathyroidism. SAVS is useful in bilateral adrenal tumors.
摘要
一名43岁的日本女性因身体虚弱入院。实验室检查结果显示低钾血症、低钙血症以及血清肌酐磷酸激酶水平升高，但甲状旁腺激素水平正常。进一步评估表明她患有原发性醛固酮增多症（PA）、继发性甲状旁腺功能亢进和双侧肾上腺肿瘤。她通过腹腔镜右肾上腺切除术获得成功治疗。该病例不仅有助于诊断双侧肾上腺肿瘤，其中选择性肾上腺静脉采血（SAVS）被证明是有用的，而且让医生意识到继发性甲状旁腺功能亢进以及PA所致继发性骨质疏松的风险。
学习要点
PA的典型表现为高血压和低钾血症。低钾血症可诱发横纹肌溶解。PA导致继发性甲状旁腺功能亢进。PA患者存在继发性甲状旁腺功能亢进导致骨质疏松的风险。SAVS对双侧肾上腺肿瘤有用。
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