Two patients had a long history of hypertension and one of them also had a nephrotic-range proteinuria secondary to focal segmental scleronephrosis which had been diagnosed by kidney biopsy. They presented with uncont...Two patients had a long history of hypertension and one of them also had a nephrotic-range proteinuria secondary to focal segmental scleronephrosis which had been diagnosed by kidney biopsy. They presented with uncontrolled hypertension. Laboratory examination suggested hypersecretion of catecholamines by the left adrenal glands in both patients and primary aldosteronism in one of them. A computed tomography scan revealed small nodules on left adrenal gland in both patients. Patients underwent laparoscopic left adrenalectomy. After surgery, blood pressure was normalized and proteinuria was resolved. Most interestingly, prominent adipocytes infiltrated were detected in the adrenal cortex and were associated with the presence of lymphocytes, which suggested that adipocytes might have a role in the pathogenesis of these diseases in our patients.展开更多
The features of the symptom s,laboratory tests and pathological characteristics of a- drenal cortical and m edullary hyperplasia were studied. In 6 cases of hypercatecholaminenia,plas- ma norepinephrine(NE) ,epineph...The features of the symptom s,laboratory tests and pathological characteristics of a- drenal cortical and m edullary hyperplasia were studied. In 6 cases of hypercatecholaminenia,plas- ma norepinephrine(NE) ,epinephrine(E) ,catecholam ine(CA) and2 4 - h urinary vanillylmandelic acid(VMA) ,17- hydroxycorticosteroid (OHCS) and 17- ketosteroid (KS) were determ ined.A- drenal glands were exam ined by CT scan and 1 31 I- MIBG imaging.Pathological examination was performed after operation.The results showed that in 6 cases of hypercatecholaminenia(3m en and 3women) aged from 34- 5 0 years,the clinical features were just like“pheochromocytoma”, for example,episodic headache,perspiration,palpitation,pallor,apprehension,nausea,tremor, anxiety and so on. Plasma levels of CA,NE and E were elevated in all 6 cases. 2 4 - h urinary sam - ples obtained atthe onsetrevealed elevated VMA in1case. 2 4 - h urinary cortisol was obviously el- evated in all6 cases. 2 4 - h urinary17- OHCS,17- KS was norm al.B- type ultrasound,CT,MRI and1 31 I- MIBG revealed9lateral adrenal gland diffuse or nodular enlargem entin6 cases.Patholog- ic exam ination showed adrenal cortical and medullary hyperplasia.Clinically,adrenal cortical and m edullary hyperplasia resembled“pheochromocytom a”. The m ost significant feature of this dis- ease was both elevated plasma CA and 2 4 - h urinary cortisol obviously. Pathologic exam ination showed adrenal cortex nodular hyperplasia and medullar diffuse or lim it hyperplasia. Whether it is an independent disease or symptoms of the other disease has not final conclusion up till now展开更多
文摘Two patients had a long history of hypertension and one of them also had a nephrotic-range proteinuria secondary to focal segmental scleronephrosis which had been diagnosed by kidney biopsy. They presented with uncontrolled hypertension. Laboratory examination suggested hypersecretion of catecholamines by the left adrenal glands in both patients and primary aldosteronism in one of them. A computed tomography scan revealed small nodules on left adrenal gland in both patients. Patients underwent laparoscopic left adrenalectomy. After surgery, blood pressure was normalized and proteinuria was resolved. Most interestingly, prominent adipocytes infiltrated were detected in the adrenal cortex and were associated with the presence of lymphocytes, which suggested that adipocytes might have a role in the pathogenesis of these diseases in our patients.
文摘The features of the symptom s,laboratory tests and pathological characteristics of a- drenal cortical and m edullary hyperplasia were studied. In 6 cases of hypercatecholaminenia,plas- ma norepinephrine(NE) ,epinephrine(E) ,catecholam ine(CA) and2 4 - h urinary vanillylmandelic acid(VMA) ,17- hydroxycorticosteroid (OHCS) and 17- ketosteroid (KS) were determ ined.A- drenal glands were exam ined by CT scan and 1 31 I- MIBG imaging.Pathological examination was performed after operation.The results showed that in 6 cases of hypercatecholaminenia(3m en and 3women) aged from 34- 5 0 years,the clinical features were just like“pheochromocytoma”, for example,episodic headache,perspiration,palpitation,pallor,apprehension,nausea,tremor, anxiety and so on. Plasma levels of CA,NE and E were elevated in all 6 cases. 2 4 - h urinary sam - ples obtained atthe onsetrevealed elevated VMA in1case. 2 4 - h urinary cortisol was obviously el- evated in all6 cases. 2 4 - h urinary17- OHCS,17- KS was norm al.B- type ultrasound,CT,MRI and1 31 I- MIBG revealed9lateral adrenal gland diffuse or nodular enlargem entin6 cases.Patholog- ic exam ination showed adrenal cortical and medullary hyperplasia.Clinically,adrenal cortical and m edullary hyperplasia resembled“pheochromocytom a”. The m ost significant feature of this dis- ease was both elevated plasma CA and 2 4 - h urinary cortisol obviously. Pathologic exam ination showed adrenal cortex nodular hyperplasia and medullar diffuse or lim it hyperplasia. Whether it is an independent disease or symptoms of the other disease has not final conclusion up till now
