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与3型自身免疫性多内分泌综合征相关的原发性醛固酮增多症:一例罕见病例报告。

Primary hyperaldosteronism associated with type 3 autoimmune polyendocrine syndrome: A rare case report.

作者信息

Li Xuesong, Gu Liangbiao, Zhao Wenhui, Xiao Jianzhong, Cao Chenxiang

机构信息

School of Clinical Medicine Tsinghua University Beijing China.

Department of Endocrine and Metabolism Beijing Tsinghua Changgung Hospital Beijing China.

出版信息

Clin Case Rep. 2024 Aug 5;12(8):e9256. doi: 10.1002/ccr3.9256. eCollection 2024 Aug.

Abstract

KEY CLINICAL MESSAGE

Primary hyperaldosteronism with type 3 autoimmune polyendocrine syndrome was a rare combination of both hyper- and hypoendocrine gland function. Comprehensive treatment including surgery and replacement therapy might be an effective strategy.

ABSTRACT

Primary aldosteronism (PA) is a common cause of secondary hypertension originating from hormones. Type 3 autoimmune polyendocrine syndrome (APS-3) is characterized by the simultaneous or subsequent occurrence of autoimmune-mediated endocrine gland damage, except for Addison disease. Here we reported an extremely rare case of a 63-year-old woman with PA and APS-3 who initially presented with hypertension (HT). The APS-3 of this patient mainly exhibited type 1 diabetes mellitus (T1DM) and Hashimoto's thyroiditis. She underwent the adrenal adenoma resection with a histopathologic diagnosis of adrenal cortical adenoma. After surgery, the HT of this patient was immediately reversed, and the concentration of serum potassium went back to normal. Then, this patient was administered with replacement therapy of insulin and levothyroxine sodium tablets (L-T4).

摘要

关键临床信息

原发性醛固酮增多症合并3型自身免疫性多内分泌腺综合征是一种内分泌腺功能亢进与减退并存的罕见组合。包括手术和替代治疗在内的综合治疗可能是一种有效的策略。

摘要

原发性醛固酮增多症(PA)是继发性高血压的常见激素病因。3型自身免疫性多内分泌腺综合征(APS-3)的特征是除艾迪生病外,自身免疫介导的内分泌腺损伤同时或相继发生。在此,我们报告了一例极为罕见的63岁女性患者,她患有PA和APS-3,最初表现为高血压(HT)。该患者的APS-3主要表现为1型糖尿病(T1DM)和桥本甲状腺炎。她接受了肾上腺腺瘤切除术,组织病理学诊断为肾上腺皮质腺瘤。术后,该患者的高血压立即得到缓解,血清钾浓度恢复正常。随后,该患者接受了胰岛素和左甲状腺素钠片(L-T4)的替代治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b4ed/11298989/89e8c8c11236/CCR3-12-e9256-g001.jpg

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