It's engraved. Maybe Sun is really the disease. It's not necessarily a disease in your neurology.

The neurologist laughed and said, "Will you still go to our department like this?" or go to the endocrinology department?"

Then go to the endocrinology department. I was wrong tonight. I touched the head that was not full of hair and smiled awkwardly.

Of course, these conversations are spoken where patients and families cannot hear them.

He sent the neurology department away and called the endocrinologist down again.

Ms. Sun saw two doctors consulting in a short time and felt vaguely worried. Could it be that the disease is more difficult.

After listening to the condition, the endocrinologist nodded slowly and said that this situation was indeed considered as the possibility of primary aldehyde (primary aldosterone hyperplasia). If it is not handled in time, if the patient has no strength in the respiratory muscles and has respiratory failure, it will be troublesome.

After hearing this, Ms. Sun suddenly felt that she had difficulty breathing and her face looked scared.

Seeing this, the emergency department doctor said that we have taken emergency measures and are already replenishing electrolytes for you. Generally, there will be no major problems. Don’t worry too much, just cooperate with us.

I was admitted to the endocrinology department that night.

When the electrolyte was checked in the early morning, the blood potassium had risen to 2.9mmol/L, which was a little higher than before. Ms. Sun felt that her hands and feet were also slightly better. When the doctor went to the bedside to check, she finally smiled a little.

The feeling of losing strength in hands and feet is really helpless, Ms. Sun said.

Your wife has high blood pressure, so you should accompany her to the hospital for examination early in the morning, rather than letting it go. If you came to the hospital earlier, maybe you might find the problem earlier, and you wouldn't be the case today.

It’s all your fault. The doctor pointed at Ms. Sun’s husband half-jokingly and said.

It was me, I blamed me for not taking good care of my wife. I hope the doctor can do my best to help us. I am grateful. Ms. Sun’s husband looked sincere.

Early the next morning, the director of the endocrinology department came to check the rounds.

After listening to the medical history report, the director agreed that the possibility of primary aldosterone is first considered. The director explained to Ms. Sun that there is a small gland on the human kidney, called the adrenal glands. The adrenal glands secrete many hormones, one of which is aldosterone. If there is too much aldosterone secretion due to certain pathological factors, problems will arise. Because aldosterone itself causes sodium retention, potassium excretion, extracellular fluid expansion, blood volume, etc., you will have symptoms such as hypertension and hypokalemia. Hypokalemia will cause muscle weakness. The lower the blood potassium, the more muscles are involved. Simply put, there is a series of symptoms in your body.

picture

(The yellow triangle hat in the picture above is the adrenal gland)

The director's words were easy to understand and friendly, which made Ms. Sun cry. But what Ms. Sun didn't understand was when her illness began and why it suddenly became so serious.

Your disease may have been a long time, or it may have only happened recently. It is hard to say. As for why it worsens, it is probably related to your exercise. Studies have shown that exercise, or the use of diuretics, etc. will induce the disease to worsen. Generally, the lower limbs are weak first, then the upper limbs are weak, and finally the respiratory muscles are weak, and some people are weak in swallowing.

Next, we need to check clearly whether you have this disease. Just check the hormone levels in the blood and you will know. The director told Ms. Sun.

The plasma aldosterone concentration and urinary aldosterone concentration were checked on the same day. Since the aldosterone concentration in the body is affected by the body position, the aldosterone concentration is low when lying, and the aldosterone concentration is high when lying, so blood should be drawn separately in Ms. Sun's position and lying.

I also checked the levels of renin and angiotensin II. Both hormones are related to aldosterone concentrations, and these hormone levels are closely related. Thyroxine and thyroid ultrasound were also done. Because hyperthyroidism can also lead to hypokalemia muscle weakness. The director said, don’t forget to check for hyperthyroidism, this has been learned.

After undergoing hormone tests, we need to undergo further adrenal CT. The director said that hormone levels can only indicate that the hormones in the body are really high, but what causes the elevation? Is it because of the tumor, hyperplasia, or other problems? CT still needs to be further confirmed. For example, there are now a group of secret killers (aldosterone) in the world. As decent people, we not only can only find these killers, but also can find their nests and take their nests into a pot, which is considered as a way to go for the sky. Where is this nest? Is there only one training ground, or there are several divisions, which can only be determined by CT. It is very important to see if there is a problem with the adrenal gland on one side or the problems on both sides, whether the tumor is one or multiple, whether it is big or not, whether it can be removed surgically.

Ms. Sun understood the director's metaphor at once.

The result came out, and the aldosterone level in the plasma increased significantly, confirming the diagnosis of aldosterone.

At that time, the drug spironolactone was used. The drug spironolactone was specifically used to fight aldosterone. The function of aldosterone was to maintain sodium and expel potassium, while the opposite was to preserve potassium and excrete sodium.

The CT results in the afternoon also came out.

As expected, Ms. Sun had a small tumor on her left adrenal gland. The tumor was not very large, with a diameter of about 0 or 7 mm. It would not be easy to see without high-resolution CT.

It is probably an aldosterone tumor. It is precisely because of the existence of this tumor that the secretion of aldosterone has increased, which has caused a series of subsequent problems, including increased blood pressure (Ms. Sun officially diagnosed with hypertension, which was also used to have it, but it was not diagnosed), hypokalemia, and weakness in the limbs.

The truth is revealed.

It is not a stroke, not myasthenia gravis, nor hyperthyroidism, nor rhabdomyolysis, but analdosterone aphrodisiac caused by this aldosterone tumor.

The director joked that you can buy lottery tickets. About 10% of the people with hypertension are hypertension caused by increased aldosterone. This hypertension is difficult to control no matter how you use antihypertensive drugs. Only using spironolactone, or surgically cutting off the tumor.

Director, is this tumor malignant? Will it metastasize? Ms. Sun’s husband is most concerned about this issue.

It looks like an adenoma, which can be said to be a benign tumor. As long as the surgery can be removed, the problem is not big. However, there are few possibilities for aldosterone cancer, which is malignant. The specific requirement is surgery to perform a pathological tissue examination.

God blesses me, it must be an adenoma, not a cancer. Ms. Sun recites silently by herself.

This time, God has made peace, the operation was successfully completed, and the pathological result was a benign adenoma.

Everyone was very happy.

Before the operation, Ms. Sun's blood potassium had been replenished to normal and her limb strength had recovered.
Chapter completed!