Sedhai Yub Raj, Reddy Kruthika, Patel Dhruvan, Lozada James A
Department of Internal Medicine, Mercy Catholic Medical Center, Darby, Pennsylvania, USA.
BMJ Case Rep. 2016 Oct 19;2016:bcr2016216961. doi: 10.1136/bcr-2016-216961.
Pheochromocytoma is a rare catecholamine-secreting tumour that arises from chromaffin cells in the adrenal medulla or extra-adrenal sympathetic ganglia. It classically presents with paroxysmal headaches, hypertension, palpitations and sweating related to catecholamine excess. Diabetes is reported to be present in approximately one-third of patients with pheochromocytoma; however, diabetic ketoacidosis is an extremely rare complication. We present a case of an African-American male aged 30 years who initially presented with diabetic ketoacidosis and hypertensive urgency whose blood pressure and glycaemic control improved remarkably following tumour excision. We will discuss this unusual presentation of pheochromocytoma along with a management approach for such adrenal incidentalomas.
嗜铬细胞瘤是一种罕见的分泌儿茶酚胺的肿瘤，起源于肾上腺髓质或肾上腺外交感神经节的嗜铬细胞。其典型表现为与儿茶酚胺过量相关的阵发性头痛、高血压、心悸和出汗。据报道，约三分之一的嗜铬细胞瘤患者患有糖尿病；然而，糖尿病酮症酸中毒是一种极其罕见的并发症。我们报告一例30岁非裔美国男性患者，最初表现为糖尿病酮症酸中毒和高血压急症，肿瘤切除后血压和血糖控制显著改善。我们将讨论嗜铬细胞瘤这种不寻常的表现以及此类肾上腺偶发瘤的处理方法。
