Sanna A L, Ciampani T, Mancini G, Giannini D, Bonifacio V
Dipartimento di Medicina Sperimentale Università degli Studi di Roma La Sapienza, Roma.
Minerva Med. 1996 Mar;87(3):93-7.
Although primary hyperaldosteronism is an uncommon cause of hypertension, it is the most common form of renin-independent hypermineralocorticoidism. The plasma aldosterone concentration and PRA with orthostatic test and saline infusion test are very useful aids to make a diagnosis. In this case the inconsistency between hormonal data and morphologic images (TC and NMR) led us to a dilemma: it was a question of adrenal adenoma or hyperplasia? Because it was impossible to dose the 18-OH-corticosterone, we had to perform a iodocholesterol scintigraphy NP 59. To distinguish an hyperplasia as cause of this kind of hyperaldosteronism made us able to define a therapeutic program useful to hypertension control.
虽然原发性醛固酮增多症是高血压的一个不常见病因，但它是肾素非依赖性高盐皮质激素血症最常见的形式。血浆醛固酮浓度以及立位试验和盐水输注试验时的血浆肾素活性，对诊断非常有帮助。在这个病例中，激素数据与形态学影像（CT和核磁共振）之间的不一致使我们陷入了两难境地：这是肾上腺腺瘤还是增生的问题？由于无法测定18-羟皮质酮，我们不得不进行NP-59碘胆固醇闪烁扫描。鉴别这种醛固酮增多症的病因是增生，这使我们能够确定一个有助于控制高血压的治疗方案。
