Uehara Y, Kuroiwa H, Shimizu H, Sato N, Shimomura Y, Mori M
Department of Internal Medicine, Ohta General Hospital, Gunma Japan.
J Med. 1993;24(2-3):193-202.
A 51-year-old male was admitted to our hospital because of glucosuria and an abdominal tumor. While blood pressure levels were maintained within normal ranges, serum adrenaline and noradrenaline levels and the urinary excretion of total metanephrine increased. The oral glucose tolerance test (75g-OGTT) showed a diabetic pattern. Venography and blood sampling from the adrenal vein showed the existence of a right adrenal tumor. Right adrenalectomy normalized serum catecholamine levels and the urinary excretion of metanephrine. Simultaneously, fasting glucose levels returned to normal. The present case suggested that increased metanephrine secretion may affect only pancreatic insulin secretion, but not blood pressure levels in the patient with asymptomatic pheochromocytoma.
一名51岁男性因糖尿和腹部肿瘤入住我院。尽管血压水平维持在正常范围内，但血清肾上腺素和去甲肾上腺素水平以及总间甲肾上腺素的尿排泄量增加。口服葡萄糖耐量试验（75g-OGTT）显示为糖尿病模式。静脉造影和肾上腺静脉采血显示存在右肾上腺肿瘤。右肾上腺切除术使血清儿茶酚胺水平和间甲肾上腺素的尿排泄量恢复正常。同时，空腹血糖水平恢复正常。本病例提示，间甲肾上腺素分泌增加可能仅影响无症状嗜铬细胞瘤患者的胰腺胰岛素分泌，而不影响血压水平。
