Lai F C, Chen H C, Peng H C, Chang W T, Wen M C
Department of Surgery, Taichung Veterans General Hospital, Taiwan, R.O.C.
Zhonghua Yi Xue Za Zhi (Taipei). 1994 Oct;54(4):274-8.
Primary aldosteronism caused by an aldosterone-producing adrenal adenoma was documented in an 11-year-old girl who presented with persistent hypertension, headache, tinnitus and hypokalemia. Elevated plasma aldosterone concentration (PAC) (45.5 ng/dl) and suppressed plasma renin activity (PRA) (< 0.3 ng/ml/hrs) were detected. Saline infusion test and postural test helped to confirm the diagnosis. The tumor site was localized by magnetic resonance imaging (MRI). Surgical removal of the tumor yielded dramatic improvement in blood pressure; PAC and PRA returned to normal range. This rare case illustrates the feasibility of recognition and localization of adrenal adenoma in children. The high cure rate by surgical excision warrants careful screening of hypertensive patients with this entity.
一名11岁女孩被诊断为原发性醛固酮增多症,病因是产生醛固酮的肾上腺腺瘤,她出现了持续性高血压、头痛、耳鸣和低钾血症。检测到血浆醛固酮浓度(PAC)升高(45.5 ng/dl),血浆肾素活性(PRA)降低(< 0.3 ng/ml/小时)。盐水输注试验和体位试验有助于确诊。通过磁共振成像(MRI)确定了肿瘤位置。手术切除肿瘤后血压显著改善;PAC和PRA恢复到正常范围。这个罕见病例说明了儿童肾上腺腺瘤识别和定位的可行性。手术切除的高治愈率值得对患有该疾病的高血压患者进行仔细筛查。