Palabras clave
Hiperprolactinemia
Hipertensión
Hiperaldosteronismo
Adenoma
Adrenalectomía
Cómo citar
Resumen
Introducción: los prolactinomas son el tipo más común de tumor hipofisario, donde los pacientes con prolactinomas presentan signos y síntomas de hipogonadismo y galactorrea. Por su parte, el aldosteronismo primario (AP) es una causa infradiagnosticada de hipertensión, caracterizada por una secreción autónoma de aldosterona. La concomitancia de estos dos síndromes ha sido reportada con poca frecuencia en la literatura.
Objetivo: presentar un caso de coexistencia de prolactinoma-AP con el fin de destacar la ocurrencia conjunta de ambas entidades y exponer el potencial vínculo fisiopatológico entre la hiperprolactinemia/prolactinoma y el AP.
Presentación del caso: mujer de 38 años con historia de varios años de oligomenorrea sin galactorrea. Bioquímica inicial con hiperprolactinemia y resonancia magnética de silla turca que reveló un prolactinoma. Durante el seguimiento, la paciente cursa con hipertensión arterial de difícil control, por lo que se exploró una causa secundaria que reveló un ratio aldosterona/actividad de renina plasmática de 232 ng/dl/ng/ml/h en presencia de un adenoma suprarrenal izquierdo de 10 mm, lo que confirmó el diagnóstico de hiperaldosteronismo primario.
Discusión y conclusión: la coexistencia de estos dos hallazgos es una condición raramente descrita en la literatura y se plantea la hipótesis de que las concentraciones elevadas de PRL podrían desempeñar un papel en la patogénesis del AP en pacientes que no forman parte del síndrome genético de neoplasia endocrina múltiple tipo 1 (MEN1 por sus siglas en inglés).
Citas
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