알도스테론 분비선종에서 편측 부신 제거술 후 발생한 일과성 저레닌성 저알도스테론증 1예

• Published in: Endocrinology and metabolism (Seoul) pp. 502 - 506
• Main Authors: 서정호, 고관표, 박근용, 홍종욱, 전숙, 오승준, 우정택, 김성운, 김진우, 김영설
• Format: Journal Article
• Language: Korean
• Published: 대한내분비학회 01-10-2005
• Subjects: 내과학
• ISSN: 2093-596X; 2093-5978

편측성 부신 선종에 대하여 부신절제술을 할 경우 거의 대부분에서 저칼륨혈증이 조절되고, 60~80%에서 고혈압이 조절되는 것으로 알려져 있다. 저자들은 부신피질선종에 의한 원발성 알도스테론증 환자에서 편측 부신절제술 후에 일과성으로 생긴 저레닌성 저알도스테론증 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Primary aldosteronism is due to either a unilateral adrenal adenoma or bilateral hyperplasia of the adrenal cortex in most cases. A unilateral adrenalectomy in hypertensive and hypokalemic patients, with a well-documented adrenal adenoma, is usually followed by the correction of hypokalemia in all subjects, with the cure of hypertension in 60 to 87% of patients. Here, a unique case, in which a unilateral adrenalectomy for the removal of an adrenal adenoma was followed by severe hyperkalemia, low levels of plasma renin activity and serum aldosterone, suggestive of chronic suppression of the renin-aldosterone axis, is reported. In a follow-up Lasix stimulation test on the 70th day after surgery, the suppression of the renin-aldosterone axis was resolved, indicating the suppression was transient. Patients undergoing a unilateral adrenalectomy for an aldosterone-producing adenoma should be closely followed up to avoid severe hyperkalemia KCI Citation Count: 1