Li J T, Shu S G, Chi C S
Department of Paediatrics, Taichung Veterans General Hospital, Taiwan, Republic of China.
Eur J Pediatr. 1994 Jul;153(7):480-2. doi: 10.1007/BF01957000.
We report a rare case of primary hyperaldosteronism in an 11-year-old female patient due to a unilateral adrenal cortical adenoma. The patient presented with hypertension, hypokalaemia and metabolic alkalosis associated with inappropriate kaliuresis. The diagnosis was supported by the following laboratory findings: elevated plasma aldosterone, suppressed plasma renin activity, nonsuppressible aldosterone secretion following saline infusion and absent plasma aldosterone response to ambulation. MRI revealed a 1 cm diameter adrenal tumour on the left side. Even though the NP-59 scintigraphy gave a negative result, laparotomy with left adrenalectomy was performed. Pathological examination confirmed an adenoma in the adrenal cortex. The patient's blood pressure and biochemical laboratory data normalized postoperatively within 2 days. We recommended that in hypertensive children with hypokalaemia and metabolic alkalosis, primary aldosteronism should be considered.
我们报告了一例罕见的11岁女性原发性醛固酮增多症病例，病因是单侧肾上腺皮质腺瘤。该患者表现为高血压、低钾血症和代谢性碱中毒，并伴有不适当的尿钾增多。以下实验室检查结果支持该诊断：血浆醛固酮升高、血浆肾素活性受抑制、盐水输注后醛固酮分泌不可抑制以及步行后血浆醛固酮无反应。MRI显示左侧有一个直径1厘米的肾上腺肿瘤。尽管NP-59闪烁扫描结果为阴性，但仍进行了剖腹手术并切除左侧肾上腺。病理检查证实肾上腺皮质有腺瘤。术后2天内，患者的血压和生化实验室数据恢复正常。我们建议，对于患有低钾血症和代谢性碱中毒的高血压儿童，应考虑原发性醛固酮增多症。
