de Gennes J L, Jacquenod P, Doumith R, Turpin G
Ann Med Interne (Paris). 1983;134(3):195-202.
Hypertension may be a prominent and sometimes the dominant expression of tumours of the adrenal cortex as demonstrated in a personal series of 9 cases and in comparable series in the literature. It is therefore important, despite their relatively low incidence, to recognise adrenal cortical tumours as the cause of hypertension. The present study was undertaken to show that this diagnosis is relatively easy. The simplest indicators are:--the change in body electrolytes with hypokalaemia and hyper-kaliuria is practically constant and should prompt a hormonal investigation to demonstrate increases adrenal secretion of mineralocorticoids;--there is also a high incidence, despite the variable profiles of plasma and urinary corticosteroids, of paradoxical lowering of plasma aldosterone in parallel with normal or low PRA which does not react to orthostatism. These two preliminary investigations are the prelude and invitation to the measurement of other mineralocorticoids, especially desoxycorticosterone secondary to a relative block of 11-betahydroxylation from what other in vivo and in vitro studies have shown. Repeated monitoring of the preceding investigations is important for the post-operative follow-up and diagnosis of recurrences or metastases.
高血压可能是肾上腺皮质肿瘤的一个突出表现，有时甚至是主要表现，这在本人收集的9例病例系列以及文献中的类似病例系列中都得到了证实。因此，尽管肾上腺皮质肿瘤导致高血压的发病率相对较低，但认识到其作为高血压病因的可能性非常重要。本研究旨在表明这种诊断相对容易。最简单的指标如下：——身体电解质变化伴低钾血症和高钾尿症几乎是恒定的，应促使进行激素检查以证实肾上腺盐皮质激素分泌增加；——尽管血浆和尿皮质类固醇的水平各不相同，但血浆醛固酮水平反常降低且伴有正常或低肾素活性（PRA），且立位试验无反应的情况也很常见。这两项初步检查是进一步测量其他盐皮质激素的前奏和指引，特别是根据体内外其他研究结果显示，因11-β羟化相对受阻而产生的脱氧皮质酮。对上述检查进行反复监测对于术后随访以及复发或转移的诊断很重要。
