Chung Seung Min
Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea.
J Yeungnam Med Sci. 2024 Oct;41(4):269-278. doi: 10.12701/jyms.2024.00752. Epub 2024 Sep 19.
Most cases of high blood pressure have no identifiable cause, termed essential hypertension; however, in approximately 15% of cases, hypertension occurs due to secondary causes. Primary aldosteronism (PA) and pheochromocytoma and paraganglioma (PPGL) are representative endocrine hypertensive diseases. The differentiation of endocrine hypertension provides an opportunity to cure and prevent target organ damage. PA is the most common cause of secondary hypertension, which significantly increases the risk of cardiovascular disease compared to essential hypertension; thus, patients with clinical manifestations suggestive of secondary hypertension should be screened for PA. PPGL are rare but can be fatal when misdiagnosed. PPGL are the most common hereditary endocrine tumors; therefore, genetic testing using next-generation sequencing panels is recommended. Herein, we aimed to summarize the characteristic clinical symptoms of PA and PPGL and when and how diagnostic tests and treatment strategies should be performed.
大多数高血压病例没有可识别的病因，称为原发性高血压；然而，在大约15%的病例中，高血压是由继发性病因引起的。原发性醛固酮增多症（PA）以及嗜铬细胞瘤和副神经节瘤（PPGL）是典型的内分泌性高血压疾病。内分泌性高血压的鉴别诊断为治愈疾病和预防靶器官损害提供了机会。PA是继发性高血压最常见的病因，与原发性高血压相比，它显著增加了心血管疾病的风险；因此，有继发性高血压临床表现的患者应接受PA筛查。PPGL很少见，但误诊时可能致命。PPGL是最常见的遗传性内分泌肿瘤；因此，建议使用二代测序技术进行基因检测。在此，我们旨在总结PA和PPGL的特征性临床症状，以及何时以及如何进行诊断检查和治疗策略。
