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一名患有单侧肾上腺增生的年轻患者的高血压急症:一例原发性醛固酮增多症病例

Hypertensive Emergency in a Young Patient With Unilateral Adrenal Hyperplasia: A Case of Conn's Syndrome.

作者信息

Ganta Nagapratap, Choe Suhrim, Kanukuntla Anish, Kata Priyaranjan, Cheriyath Pramil

机构信息

Internal Medicine, Hackensack Meridian Ocean Medical Center, Brick, USA.

出版信息

Cureus. 2021 Sep 6;13(9):e17773. doi: 10.7759/cureus.17773. eCollection 2021 Sep.

Abstract

Aldosterone is a mineralocorticoid hormone that maintains sodium and potassium homeostasis. Excess aldosterone secretion causes sodium influx and potassium outflow, leading to hypertension and in some cases hypokalemia. Conn's syndrome, or primary aldosteronism, is the most common cause of secondary hypertension, accounting for 20% or more of people with resistant hypertension. We present a young male with hypertension, blurry vision in the right eye, and hypokalemia who was on further investigation found to have an aldosterone-secreting adrenal adenoma. He was treated with retroperitoneoscopic right-sided adrenalectomy and his blood pressure improved. Conn's syndrome should be suspected in any hypertensive patient with hypokalemia. Adrenal venous sampling is the best investigation to measure aldosterone levels and also to lateralize the source. Surgical resection is the treatment of choice.

摘要

醛固酮是一种维持钠钾稳态的盐皮质激素。醛固酮分泌过多会导致钠内流和钾外流,从而引发高血压,在某些情况下还会导致低钾血症。原发性醛固酮增多症,即康恩综合征,是继发性高血压最常见的病因,在顽固性高血压患者中占比达20%或更多。我们报告了一名年轻男性,患有高血压、右眼视物模糊和低钾血症,进一步检查发现其患有分泌醛固酮的肾上腺腺瘤。他接受了后腹腔镜右侧肾上腺切除术,血压得到改善。任何伴有低钾血症的高血压患者都应怀疑患有康恩综合征。肾上腺静脉采血是测量醛固酮水平并确定其来源的最佳检查方法。手术切除是首选的治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f24/8494148/c0d36a1ae45a/cureus-0013-00000017773-i01.jpg

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