Rosales-Castillo A, Bustos-Merlo A
Servicio de Medicina Interna, Hospital Universitario Virgen de las Nieves, Granada, Spain.
Servicio de Medicina Interna, Hospital Universitario Virgen de las Nieves, Granada, Spain.
Hipertens Riesgo Vasc. 2022 Apr-Jun;39(2):92-94. doi: 10.1016/j.hipert.2021.09.002. Epub 2021 Oct 13.
Arterial hypertension is generally classified as primary or essential (90%), and secondary (10%). Infrequent causes of the latter include Cushing's syndrome, classified as ACTH-dependent and independent. A small percentage of ACTH-independent cases are due to ectopic ACTH secretion, generally due to neoplasia, and can present as arterial hypertension and hyperglycaemia that are refractory to pharmacological measures, metabolic alkalosis and hypokalaemia that are difficult to control, but which help guide the initial diagnosis. We present two clinical cases with a diagnosis of ectopic ACTH secretion secondary to small cell lung carcinoma, in which one of the debut manifestations was unknown, difficult to control arterial hypertension.
动脉高血压通常分为原发性或特发性(90%)和继发性(10%)。后者的罕见病因包括库欣综合征,分为促肾上腺皮质激素(ACTH)依赖性和非依赖性。一小部分ACTH非依赖性病例是由于异位ACTH分泌,通常由肿瘤引起,可表现为对药物治疗无效的动脉高血压和高血糖、难以控制的代谢性碱中毒和低钾血症,但这些有助于指导初步诊断。我们报告两例诊断为小细胞肺癌继发异位ACTH分泌的临床病例,其中首发表现之一为不明原因的、难以控制的动脉高血压。