Department of Endocrinology, Chongqing General Hospital, Chongqing, China.
Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Front Endocrinol (Lausanne). 2020 Sep 4;11:593. doi: 10.3389/fendo.2020.00593. eCollection 2020.
Aldosterone-producing adenoma (APA) is a main cause of primary aldosteronism (PA). Given that a large benign-appearing unilateral masse (>1 cm in diameter) may represent an aldosterone and cortisol-co-secreting adenoma, dexamethasone suppression testing is required in such patients to exclude or confirm the diagnosis of hypercortisolism. Tuberculosis is highly prevalent in China, and rifamycins are often used in these patients. Rifapentine belongs to the rifamycin family, and we herein for the first time report a case of misdiagnosis of hypercortisolism due to rifapentine use in a patient with APA. Thus, in patients treated with rifapentine, diagnosis of hypercortisolism based on dexamethasone suppression tests can be very misleading.
醛固酮瘤（APA）是原发性醛固酮增多症（PA）的主要病因。由于大的良性单侧肿块（直径>1 厘米）可能代表醛固酮和皮质醇共同分泌的腺瘤，因此需要对这些患者进行地塞米松抑制试验以排除或确认皮质醇增多症的诊断。在中国，结核病的发病率很高，这些患者经常使用利福霉素类药物。利福平属于利福霉素类药物，我们在此首次报告了一例因 APA 患者使用利福平而导致皮质醇增多症误诊的病例。因此，在使用利福平的患者中，基于地塞米松抑制试验的皮质醇增多症诊断可能会产生很大的误导。
