알도스테론 분비 부신샘종과 동측의 신장동맥혈관협착이 동반된 1예
A Case of a Coexisting Aldosterone-Producing Adrenal Adenoma and Ipsilateral Renal Artery Stenosis
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초록
알도스테론 분비 부신샘종과 신장동맥협착을 동시에 보이는 예는 극히 드물다. 저자들은 약물로 조절되지 않은 고혈압을 주소로 내원한 52세 여자에게서 고알도스테론증을 시사하는 검사 소견이 있어 알도스테론 분비 부신샘종을 진단하였고 복강경하 좌측 부신절제술을 시행하였다. 수술로 제거하였음에도 불구하고 지속된 고혈압에 대해 평가하던 중 신장동맥혈관조영술로 좌측 신장동맥협착을 진단하였고 풍선혈관성형술을 시행하였다. 그 후 혈압은 항고혈압제 요구량이감소하면서 조절된 양상을 보였다. 본 증례는 고알도스테론증을 보이는 환자를 평가하는 데 있어 신장동맥협착 동반 여부에 대한 평가가 필요함을 강조한다.
Abstract
The simultaneous occurrence of renovascular hypertension and an aldosterone-producing adrenal adenoma is a rare entity. Here, we report the case of a 52-year-old female who had a coexisting aldosterone-producing adrenal adenoma and ipsilateral renal artery stenosis. She was diagnosed with the aldosterone-producing adrenal adenoma and then underwent a laparoscopic left adrenalectomy. Her blood pressure was uncontrolled after the adrenalectomy. Selective renal angiography showed left renal artery stenosis; thus, she underwent balloon angioplasty at the same sitting. Subsequently, her blood pressure returned to normal after administration of a single antihypertensive drug. This case suggests that it is important to recognize the possible coexistence of renal artery stenosis in a patient with an aldosterone-producing adrenal adenoma.
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