Nishimiya T, Kikuchi K, Oimatsu H, Ota S, Nakamura Y, Shimamoto K, Iimura O
Endocrinol Jpn. 1984 Apr;31(2):159-64. doi: 10.1507/endocrj1954.31.159.
A 47-year-old woman with normotensive primary aldosteronism is reported. In this case, hypopotassemia was found, but the patient's blood pressure was within the normal range. Her condition was diagnosed as primary aldosteronism without hypertension, which is very rare, based on an increased level of plasma aldosterone concentration, low plasma renin activity, and a typical finding of aldosterone-producing adenoma by adrenal scintigraphy. In the present case, similar values for urinary volume, renal function, plasma aldosterone concentration, plasma renin activity, plasma volume, total exchangeable sodium, urinary kallikrein excretion and a similar weight of the resected adenoma, but a shorter duration between the onset of symptom and hospital admission were observed as compared with those in 13 previously experienced cases of primary aldosteronism with hypertension. Thus, a shorter duration of primary aldosteronism appears to be an important factor in explaining the mechanism of normotension. However, we were unable to reach a definite conclusion and this is only a hypothesis. Further investigation will be required to clarify the mechanism of normotension in primary aldosteronism.
报告了一名患有血压正常的原发性醛固酮增多症的47岁女性。在该病例中，发现有低钾血症，但患者血压在正常范围内。根据血浆醛固酮浓度升高、血浆肾素活性降低以及肾上腺闪烁显像显示醛固酮瘤的典型表现，她的病情被诊断为无高血压的原发性醛固酮增多症，这非常罕见。与之前13例有高血压的原发性醛固酮增多症病例相比，本病例在尿量、肾功能、血浆醛固酮浓度、血浆肾素活性、血浆容量、总可交换钠、尿激肽释放酶排泄以及切除腺瘤的重量方面数值相似，但症状出现至入院的时间较短。因此，原发性醛固酮增多症病程较短似乎是解释血压正常机制的一个重要因素。然而，我们未能得出明确结论，这只是一个假设。需要进一步研究以阐明原发性醛固酮增多症中血压正常的机制。
