正常血压型原发性醛固酮增多症的诊断学特征并文献复习

目的探讨正常血压型原发性醛固酮增多症(PA)的诊断学特征。 方法回顾性分析2018年5月4日中山大学附属第三医院内分泌科收治的1例血压正常、低血钾的PA患者的临床资料,并进行文献复习。 结果患者女性,39岁,因"四肢乏力麻木3年余,加重2 d"入院,监测血压正常,实验室检查显示血钾2.10 mmol/L,血醛固酮水平升高(465.83 pmol/L),肾素浓度偏低(2.90 ng/L),CT提示右侧肾上腺皮质腺瘤(23 mm×18 mm),确诊为PA。该患者整个病程未发现高血压。 结论对低血钾麻痹而无高血压的患者,要警惕正常血压型PA的可能,避免漏诊。

Diagnostic features of normotensive primary aldosteronism and literature review

ObjectiveTo explore the diagnostic features of normotensive primary aldosteronism (PA). MethodsThe clinical data of a normotensive PA patient admitted to the Department of Endocrinology of the Third Affiliated Hospital of Sun Yat-sen University on May 4, 2018 were analyzed retrospectively and literatures were reviewed. ResultsA 39-year-old female patient was hospitalized because of 3-year limb weakness and numbness, and 2-day deterioration. The patient presented normotension, hypokalemia (2.10 mmol/L), high aldosterone level (465.83 pmol/L) and low rennin level (2.90 ng/L). CT scan displayed a right adrenal cortical adenoma (23 mm×18 mm). The patient was diagnosed with PA eventually. Interestingly, the blood pressure was normal during the whole period. ConclusionNormotensive PA should be considered when a patient presents hypokalemia paralysis without hypertension.