以严重低血钾为首发症状的垂体促肾上腺皮质激素瘤一例报告并文献复习

摘要

The paper retrospectively analyzes the clinical diagnosis and treatment process of one patient of pituitary adrenocorticotrophic hormone ( ACTH) adenoma with severe low blood potassium as initial symptom.The patient is misdiagnosed for two years due to ignorance of his signs; the patient after admission was given suppression test of small-dose and large-dose dexamethasone, pituitary MRI enhancement scan test and was finally diagnosed with Cushing′s disease; after transsphenoidal pituitary micro -adenomas surgery, patients′hypertension, blood potassium, blood glucose, cortisol and ACTH were reexamined and all were in the reference range.Besides considering as primary aldosteronism, clinician should also taking Cushing′s disease, into consideration when encounter hypertension patients combined with severe low blood potassium.%本文回顾性分析了1例以严重低血钾为首发症状的垂体促肾上腺皮质激素（ ACTH）瘤患者的临床诊治经过。由于忽视患者体征，导致误诊两年；入院后行小剂量及大剂量地塞米松抑制试验、垂体MRI增强扫描检查，确诊为库欣病；采用微腺瘤经蝶手术治疗，术后复查患者血压、血钾、血糖、皮质醇、 ACTH等均在参考范围内。提示临床医生在工作中遇到高血压伴低血钾的患者，除考虑原发性醛固酮增多症外，还应考虑库欣病。