clinmedКлиническая медицинаClinical Medicine (Russian Journal)0023-21492412-1339ООО «Медицинское информационное агентство»10.30629/0023-2149-2024-102-4-367-374clinmed-820Research ArticleЗАМЕТКИ И НАБЛЮДЕНИЯ ИЗ ПРАКТИКИNOTES AND OBSERVATIONS FROM PRACTICEПроблемы диагностики и лечения синдрома KонншингаProblems of diagnosis and treatment of Connshing syndromehttps://orcid.org/0000-0001-9911-3117АннаевМ. С.AnnaevM. S.

Аннаев Мейлис Сердарович — аспирант Школы медицины и наук о жизни

Владивосток

Meilis S. Annaev — graduate student of the School of Medicine and Life Sciences

Vladivostok

dr.meylis.card@gmail.comhttps://orcid.org/0000-0002-9250-557XГельцерБ. И.GeltserB. I.

Гельцер Борис Израйльевич — д-р мед. наук, профессор, член-корр. РАН, заместитель директора по научной работе Школы медицины и наук о жизни

Владивосток

Boris I. Geltser — Dr. of Sci. (Med.), Professor, Corresponding Member of RAS, Deputy Director for Research, School of Medicine and Life Sciences

 

Vladivostok

https://orcid.org/0000-0003-0472-9504СтегнийК. В.StegniyK. V.

Стегний Кирилл Владимирович — д-р мед. наук, профессор, членкорр. РАН, профессор департамента ординатуры и дополнительного образования Школы медицины и наук о жизни

Владивосток

Kirill V. Stegniy — Dr. of Sci. (Med.), Professor, Corresponding Member of RAS, Professor of the Department of Residency and Continuing Education, School of Medicine and Life Sciences

Vladivostok

https://orcid.org/0000-0002-1312-8308ПакО. И.PakO. I.

Пак Олег Игоревич — кандидат мед. наук, врач высшей категории, главный врач Медицинского комплекса

Владивосток

Oleg I. Pak — Cand. of Sci. (Med.), doctor of the highest category, chief physician of the Medical Complex

Vladivostok

https://orcid.org/0000-0002-6261-7511ГончарукР. А.GoncharukR. A.

Гончарук Роман Анатольевич — канд. мед. наук, врач -хирург, онколог Медицинского комплекса 

Владивосток

Roman A. Goncharuk — Cand. of Sci. (Med.), surgeon, oncologist, Medical Complex

Vladivostok

https://orcid.org/0000-0001-8321-2786СелютинС. М.SelyutinS. M.

Селютин Сергей Маркович — врач рентгенэндоваскулярных методов диагностики и лечения отделения кардиохирургии и сосудистойхирургии Медицинского комплекса

Владивосток

Sergey M. Selyutin — doctor of X-ray endovascular diagnostic methods and treatment, Department of Cardiac Surgery and Vascular Surgery, Medical Complex

Vladivostok

МорозоваА. М.MorozovaA. M.

Морозова Алла Моисеевна — канд. мед. наук, доцент департамента дополнительного образования и ординатуры Школы медицины и наук о жизни 

Владивосток

Alla M.Morozova — Cand. of Sci. (Med.),, Associate Professor of the Department of Continuing Education and Residency, School of Medicine and Life Sciences

Vladivostok

https://orcid.org/0000-0002-2947-6075ЦыганковаО. Г.TsygankovaO. G.

Цыганкова Ольга Григорьевна — заведующая ПКЦД и ЭЗ ГБУЗ ККБ №2, заведующая отделением эндокринологии 1 ПКЦД и ЭЗ ГБУЗ ККБ «2, главный внештатный специалист-эндокринолог МЗПК

Владивосток

Olga G. Tsygankova — head of the Primorsky Regional Center for Diabetes and Endocrine Diseases of the State Budgetary Healthcare Institution Сity Сlinical Hospital No. 2, chief freelance specialist endocrinologist of the Ministry of Health of the Primorye Territory

Vladivostok

https://orcid.org/0000-0002-1074-1000МаслянцевЕ. В.MaslyantsevE. V.

Маслянцев Евгений Владимирович — ассистент департамента клинической медицины Школы медицины и наук о жизни, врач-хирург центра хирургии Медицинского комплекса

Владивосток

Evgeniy V. Maslyantsev — assistant of the Department of Clinical Medicine of the School of Medicine and Life Sciences, surgeon at the Surgery Center of the Medical Complex

Vladivostok

https://orcid.org/0000-0001-9641-0159ФисенкоВ. Г.FisenkoV. G.

Фисенко Василий Геннадьевич — врач — анестезиолог-реаниматолог отделения анестезиологии, реанимации и интенсивной терапии Медицинского комплекса 

Владивосток

Vasiliy G. Fisenko — intensivist of the department of anesthesiology, resuscitation and intensive care of the Medical Complex

Vladivostok

ФГАОУ ВО «Дальневосточный федеральный университет»РоссияFar Eastern Federal UniversityRussian FederationГБУЗ «Краевая клиническая больница № 2»РоссияRegional Clinical Hospital № 2Russian Federation2024260720241024367374Copyright © Аннаев М.С., Гельцер Б.И., Стегний К.В., Пак О.И., Гончарук Р.А., Селютин С.М., Морозова А.М., Цыганкова О.Г., Маслянцев Е.В., Фисенко В.Г., 20242024Аннаев М.С., Гельцер Б.И., Стегний К.В., Пак О.И., Гончарук Р.А., Селютин С.М., Морозова А.М., Цыганкова О.Г., Маслянцев Е.В., Фисенко В.Г.Annaev M.S., Geltser B.I., Stegniy K.V., Pak O.I., Goncharuk R.A., Selyutin S.M., Morozova A.M., Tsygankova O.G., Maslyantsev E.V., Fisenko V.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.clinmedjournal.com/jour/article/view/820

Несмотря на то, что после первого описания альдостерон-кортизол-продуцирующих аденом надпочечников (синдрома Конншинга) прошло уже около 50 лет, до настоящего времени остается много нерешенных вопросов, касающихся диагностики и лечения данного заболевания. Представленный клинический случай подтверждает сложность распознавания этого заболевания ввиду частого отсутствия его манифестирующих клинических проявлений и недостаточной информативности стандартных лабораторных исследований. В этих случаях большое значение в дифференциальной диагностике редких форм первичного гиперальдостеронизма принадлежит методу сравнительного селективного забора венозной крови из надпочечников. Анализ клинических случаев, представленных в научной литературе за 2000–2023 гг., показал, что при хирургическом лечении данной патологии методом выбора является частичная адреналэктомия, выполнение которой связано с минимальным риском послеоперационных осложнений.

Despite the fact that it has been almost 50 years since the first description of aldosterone-cortisol-producing adrenal adenomas (Connshing syndrome), there are still many unresolved issues regarding the diagnosis and treatment of this condition. The presented clinical case confirms the complexity of recognizing this disease due to the frequent absence of its manifesting clinical symptoms and the lack of information acquired from standard laboratory tests. In these cases, the method of comparative selective venous blood sampling from the adrenal glands plays a significant role in the differential diagnosis of rare forms of primary hyperaldosteronism. Analysis of clinical cases presented in the scientific literature from 2000 to 2023 showed that partial adrenalectomy is the method of choice for surgical treatment of this pathology, which is associated with minimal risk of postoperative complications.

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The authors declare that there are no conflicts of interest present.