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妊娠期肾素分泌瘤的成功管理:一例报告

Successful Management of a Renin-Secreting Tumor in Pregnancy: A Case Report.

作者信息

Tamura Toshiki, Maekawa Ken, Ishida Kentaro, Kiyokawa Hikaru, Ohnishi Hiroyuki, Nonogaki Takafumi

机构信息

Obstetrics and Gynecology, Osaka Red Cross Hospital, Osaka, JPN.

Obstetrics and Gynecology, Saiseikai Noe Hospital, Osaka, JPN.

出版信息

Cureus. 2024 Nov 8;16(11):e73281. doi: 10.7759/cureus.73281. eCollection 2024 Nov.

Abstract

Hypertension that develops during early pregnancy has several causes. However, there have been no reported cases of full-term delivery, particularly when it is caused by renin-secreting renal tumors. We present the case of a 28-year-old pregnant patient who delivered with a renin-secreting renal tumor and provide a literature search of similar cases. A patient with no history of hypertension was referred to our hospital for severe hypertension during early pregnancy and was admitted for antihypertensive and aspirin therapy. The renin level of the patient was abnormally high, and a renal tumor was detected in the right kidney. Robot-assisted partial nephrectomy was performed at 16 weeks of gestation, after which antihypertensive medication was discontinued because hypertension was not observed. The pregnancy progressed favorably, leading to an uncomplicated delivery of a healthy baby at 40 weeks of gestation. The successful treatment of our patient can be attributed to three key factors: early hospitalization for strict blood pressure control, aspirin administration, and prompt diagnosis and treatment. Medication and thorough investigation of secondary hypertension are crucial in pregnant women with hypertension.

摘要

妊娠早期出现的高血压有多种病因。然而,尚无足月分娩的报道病例,尤其是由分泌肾素的肾肿瘤引起的高血压。我们报告一例28岁的妊娠患者,其患有分泌肾素的肾肿瘤并成功分娩,并对类似病例进行了文献检索。一名无高血压病史的患者因妊娠早期严重高血压转诊至我院,入院接受降压和阿司匹林治疗。患者的肾素水平异常升高,右侧肾脏检测到一个肾肿瘤。在妊娠16周时进行了机器人辅助部分肾切除术,术后因未观察到高血压而停用降压药物。妊娠进展顺利,在妊娠40周时顺利分娩出一名健康婴儿。我们患者的成功治疗可归因于三个关键因素:早期住院以严格控制血压、给予阿司匹林以及及时诊断和治疗。对高血压孕妇进行药物治疗和对继发性高血压进行全面检查至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b18/11625448/645a1f29b37d/cureus-0016-00000073281-i01.jpg

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