Manuel Sebastian L, Kender Mark
Internal Medicine, Saint Luke's Hospital, Easton, USA.
Medicine, Temple School of Medicine, Bethlehem, USA.
Cureus. 2023 Aug 9;15(8):e43195. doi: 10.7759/cureus.43195. eCollection 2023 Aug.
Hyperaldosteronism is a common cause of secondary hypertension. It has been classically associated with the clinical triad of hypertension, unexplained hypokalemia, and metabolic alkalosis. We present a case of a 66-year-old man who experienced blindness, hypokalemia, and hypertension that was resistant to anti-hypertension medications. He was found to have a retinal detachment and central retinal vein occlusion (CRVO). Laboratory evaluation revealed a marked elevation of plasma aldosterone activity and suppressed renin. A computerized tomography (CT) abdomen was subsequently ordered, which revealed bilateral adrenal nodules. Adrenal vein sampling was performed, which confirmed bilateral hyperfunctioning adrenal nodules. He was successfully treated with spironolactone. CRVO in the setting of hyperaldosteronism is an uncommon presentation.
原发性醛固酮增多症是继发性高血压的常见病因。它传统上与高血压、不明原因的低钾血症和代谢性碱中毒这一临床三联征相关。我们报告一例66岁男性病例，该患者出现失明、低钾血症以及对降压药物耐药的高血压。检查发现他患有视网膜脱离和视网膜中央静脉阻塞（CRVO）。实验室检查显示血浆醛固酮活性显著升高且肾素受抑制。随后进行了腹部计算机断层扫描（CT），结果显示双侧肾上腺结节。进行了肾上腺静脉采血，证实双侧肾上腺结节功能亢进。他通过螺内酯治疗成功康复。原发性醛固酮增多症背景下的CRVO是一种不常见的表现。
