中华检验医学杂志2024,Vol.47Issue(5) :574-577.DOI:10.3760/cma.j.cn114452-20230810-00053

屈螺酮炔雌醇片导致高醛固酮血症1例

Hyperaldosteronism caused by drospirenone and ethinylestradiol tablets:a case report

林丽灵 宋桉 马晓丽 邹雨桐 罗薇 谢少伟 禹松林 熊巍 邱玲
中华检验医学杂志2024,Vol.47Issue(5) :574-577.DOI:10.3760/cma.j.cn114452-20230810-00053

屈螺酮炔雌醇片导致高醛固酮血症1例

Hyperaldosteronism caused by drospirenone and ethinylestradiol tablets:a case report

林丽灵 1宋桉 2马晓丽 1邹雨桐 1罗薇 1谢少伟 1禹松林 1熊巍 3邱玲1
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作者信息

  • 1. 中国医学科学院,北京协和医院检验科,北京 100730
  • 2. 中国医学科学院,北京协和医院内分泌科,北京 100730
  • 3. 中国医学科学院,北京协和医院妇产科,北京 100730
  • 折叠

摘要

1例青年女性患者因痤疮、睾酮水平升高,行血浆类固醇激素谱检查发现醛固酮显著升高.排除检测干扰;核实患者无高血压、低血钾和肾上腺占位,除外原发性和继发性醛固酮增多症.随访观察到醛固酮水平与屈螺酮炔雌醇片使用有时间相关性.屈螺酮和炔雌醇通过不同机制引起醛固酮升高、醛固酮与直接肾素浓度比值升高;屈螺酮可拮抗盐皮质激素,大多数患者不会出现高血压和低钾血症.临床上,需注意此药对原发性醛固酮增多症筛查指标的影响.实验室在结果审核时,如遇无高血压、低血钾而醛固酮升高的女性患者,可核实是否有屈螺酮炔雌醇片等复方雌孕激素用药史,在报告中进行适当提示.

Abstract

A young female patient with acne and elevated testosterone level underwent plasma steroid hormones testing and found a significant increase in aldosterone.We excluded testing interference and verified the absence of hypertension,hypokalemia,and adrenal occupancy,as well as primary and secondary hyperaldosteronism.During follow-up,a temporal correlation was found between aldosterone levels and the use of drospirenone and ethinylestradiol tablets.It was observed that the combination of drospirenone and ethinylestradiol could lead to the increase of aldosterone level and the concentration ratio of aldosterone to direct renin through different mechanisms.Drospirenone exerts an antagonistic effect on mineralocorticoid receptor to prevent the development of hypertension or hypokalemia.In clinical practice,it is necessary to pay attention to the effect of this drug on screening markers for primary aldosteronism.In the laboratory examination,when female patients with no symptoms of hypertension and hypokalemia but with elevated aldosterone levels are encountered,it can be verified whether they have a history of use of compound estrogen-progestin such as drospirenone and ethinylestradiol tablets,and appropriate tips are provided in the report.

关键词

醛固酮增多症/屈螺酮/炔雌醇

Key words

Hyperaldosteronism/Drospirenone/Ethinyl estradiol

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基金项目

中央高水平医院临床研究专项(2022-PUMCH-B-073)

出版年

2024
中华检验医学杂志
中华医学会

中华检验医学杂志

CSTPCDCSCD北大核心
影响因子:1.402
ISSN:1009-9158
参考文献量20
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