Hermayer K L, Szpiech M
Department of Medicine, Medical University of South Carolina, Charleston 29425, USA.
Am J Med Sci. 1999 Sep;318(3):186-9. doi: 10.1097/00000441-199909000-00014.
Pheochromocytoma is known to increase morbidity and mortality. We describe a case of pheochromocytoma during pregnancy. A patient was transferred to our hospital during gestational week 15 with severe hypertension, acute pulmonary edema, and cardiomyopathy. One day after transfer, she had a spontaneous abortion of the fetus. One week after hospital transfer, she developed acute dyspnea, supraventricular tachycardia degenerating into ventricular tachycardia, and respiratory failure requiring mechanical ventilation. Pheochromocytoma caused by a right adrenal mass was diagnosed. The patient was treated with titrated doses of phenoxybenzamine, intravenous nicardipine, and metyrosine over a period of 3 weeks with resultant stabilization of her blood pressure. She underwent a successful right adrenalectomy 1 month after her initial presentation. Four months after surgery, all antihypertensive medications were discontinued and her blood pressure remained stable 1 year after the surgery. This case describes the maternal morbidity and fetal mortality that may be associated with pheochromocytoma during pregnancy.
已知嗜铬细胞瘤会增加发病率和死亡率。我们描述了一例妊娠期嗜铬细胞瘤病例。一名患者在妊娠第15周时因严重高血压、急性肺水肿和心肌病被转诊至我院。转诊一天后，她自然流产。住院一周后，她出现急性呼吸困难，室上性心动过速恶化为室性心动过速，并出现呼吸衰竭，需要机械通气。诊断为由右侧肾上腺肿块引起的嗜铬细胞瘤。患者在3周内接受了滴定剂量的酚苄明、静脉注射尼卡地平和甲酪氨酸治疗，血压得以稳定。首次就诊1个月后，她成功接受了右侧肾上腺切除术。术后4个月，所有抗高血压药物均停用，术后1年她的血压仍保持稳定。本病例描述了妊娠期嗜铬细胞瘤可能相关的孕产妇发病率和胎儿死亡率。
