一名服用炔雌醇/屈螺酮联合剂的年轻女性高血压的实验室调查不一致。

IF 1.6 4区 医学 Q2 Medicine Acta Clinica Belgica Pub Date : 2023-08-01 DOI:10.1080/17843286.2022.2132764
Patrice Dufour, Laurent Vroonen, Etienne Cavalier, Caroline Le Goff
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引用次数: 1

摘要

病例介绍:一名34岁女性因动脉高血压被送往急诊科。根据内分泌学家的要求,血液分析显示醛固酮水平非常高(1805 ng/L,正常值)。讨论:文献显示,乙炔雌二醇/降螺酮联合可干扰肾素-血管紧张素-醛固酮系统,增加醛固酮和/或肾素的水平。我们在这里报告了一个临床病例,说明了这种药物对年轻女性肾素-血管紧张素-醛固酮轴的显著影响。然而,这种关联并没有在干扰醛固酮和肾素水平测量的药物中列出。结论:结合文献资料和我们的临床病例,我们建议在干扰醛固酮和肾素水平测定的药物列表中增加屈螺酮和炔雌醇/屈螺酮相关性。
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Inconsistencies in laboratory investigations of hypertension in a young woman taking ethinylestradiol/drospirenone association.

Case presentation: A 34-year-old woman presented to the emergency department for arterial hypertension. Blood analysis requested by the endocrinologist showed very high level of aldosterone (1805 ng/L, normal values: <264 ng/L) and high level of renin activity (2.8 ng/mL/h, normal values: 0.1-2.0 ng/mL/h). The patient reported the use of Yasmin® (ethinylestradiol 30 µg/drospirenone 3 mg) continuously (without hormone-free week between cycles) as oral contraception. Medical imaging examinations revealed no anomaly in the kidneys and the adrenal glands. On the endocrinologist advice, patient stopped the intake of Yasmin®. Aldosterone and renin levels were measured several times after the discontinuation of the oral contraception and a diminution of these levels was observed with a complete normalization of both levels 26 days after the synthetic hormones discontinuation.

Discussion: The literature shows that ethynilestradiol/drospirenone association can interfere with the renin-angiotensin-aldosterone system and increase the levels of aldosterone and/or renin. We reported here a clinical case illustrating the significant impact of this medication on the renin-angiotensin-aldosterone axis of a young woman. However, this association is not listed among the drugs interfering with the aldosterone and renin-level measurements.

Conclusion: Considering the data in the literature and our clinical case, we suggest adding drospirenone and the ethinylestradiol/drospirenone association in the list of drugs interfering with aldosterone and renin level determination.

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来源期刊
Acta Clinica Belgica
Acta Clinica Belgica 医学-医学:内科
CiteScore
2.90
自引率
0.00%
发文量
44
审稿时长
6-12 weeks
期刊介绍: Acta Clinica Belgica: International Journal of Clinical and Laboratory Medicine primarily publishes papers on clinical medicine, clinical chemistry, pathology and molecular biology, provided they describe results which contribute to our understanding of clinical problems or describe new methods applicable to clinical investigation. Readership includes physicians, pathologists, pharmacists and physicians working in non-academic and academic hospitals, practicing internal medicine and its subspecialties.
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