收稿日期: 2023-09-04
网络出版日期: 2024-03-15
A case report of subclinical primary aldosterone complicating with subclinical Cushing syndrome and literature review
Received date: 2023-09-04
Online published: 2024-03-15
本文报告1例罕见的亚临床原发性醛固酮增多症（subclinical primary aldosteronism，SPA）合并亚临床库欣综合征（subclinical Cushing syndrome，SCS）患者。该患者为41岁的女性，因肾上腺偶发瘤（adrenal incidentaloma，AI）入院。患者无高血压、低血钾、糖代谢异常等典型的原发性醛固酮增多症（primary aldosteronism，PA）或库欣综合征（Cushing syndrome，CS）的临床表现，实验室检查示醛固酮肾素比值（aldosterone to renin ratio，ARR）>3.7，促肾上腺皮质激素（adrenocorticotropic hormone，ACTH）<1.6 pg/mL，最终依据术后病理学检查结果，患者被诊断为肾上腺皮质腺瘤。该病例中存在2种亚临床疾病共存的诊断，这种临床类型在目前的指南和报道中并未得到充分认识，值得关注并进行更详细的讨论。
关键词： 肾上腺偶发瘤; 亚临床原发性醛固酮增多症; 亚临床库欣综合征
侯怡茹, 王敏, 王春花, 陈俞洁 . 亚临床原发性醛固酮增多症合并亚临床库欣综合征1例并文献复习[J]. 诊断学理论与实践, 2023 , 22(05) : 480 -485 . DOI: 10.16150/j.1671-2870.2023.05.010
This case reports a rare subclinical primary aldosteronism complicated with subclinical Cushing’s syndrome. A 41-year-old female patient was admitted for adrenal incidentaloma, had no clinical manifestations of typical primary aldosteronism or Cushing syndrome, such as hypertension, hypokalemia, abnormal glucose metabolism. Laboratory tests indicated ARR> 3.7, ACTH <1.6 pg/mL, and a postoperative pathological diagnosis was adrenal cortical adenoma. Subclinical coexistence of both diseases was presented in this case. This type is not fully recognized in current guidelines and reports, and deserves more detailed discussion.
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