Lin Allison, Chan Stephanie J, Crapanzano John P, Kuo Eric J
Department of Endocrine Surgery, Columbia University Irving Medical Center, New York, New York, USA.
Department of Pathology & Cell Biology, Columbia University Irving Medical Center, New York, New York, USA.
BMJ Case Rep. 2025 Feb 5;18(2):e262767. doi: 10.1136/bcr-2024-262767.
Primary aldosteronism (PA) is rarely seen in pregnancy despite being a common cause of secondary hypertension. Spironolactone, the first-line treatment, is contraindicated in pregnancy due to potential anti-androgenic effects; treatment options are thus limited. We present a case in which severe hypokalaemia associated with PA was discovered during pregnancy. Eplerenone was used as a short-term treatment without adverse effects to the fetus before unilateral laparoscopic adrenalectomy was performed in the second trimester after the patient was refractory to medical treatment. This case report adds to the limited literature on management of PA in pregnancy, which could influence future risk-benefit discussions regarding surgical versus medical management of this condition.
原发性醛固酮增多症（PA）虽是继发性高血压的常见病因，但在妊娠中却很少见。一线治疗药物螺内酯因可能具有抗雄激素作用而在孕期禁用，因此治疗选择有限。我们报告一例在孕期发现与PA相关的严重低钾血症的病例。在患者药物治疗无效后，于孕中期进行单侧腹腔镜肾上腺切除术之前，依普利酮被用作短期治疗且未对胎儿产生不良影响。本病例报告补充了关于妊娠合并PA管理的有限文献，这可能会影响未来关于该疾病手术与药物治疗的风险效益讨论。
