Tate Joshua M, Gyorffy Janelle B, Colburn Jeffrey A
Endocrinology Service, Department of Medicine, San Antonio Military Medical Center, San Antonio, TX, USA.
Department of Internal Medicine, San Antonio Military Medical Center, San Antonio, TX, USA.
SAGE Open Med Case Rep. 2017 Nov 16;5:2050313X17741016. doi: 10.1177/2050313X17741016. eCollection 2017.
Neurofibromatosis type 1 is a complex, multi-system genetic disorder that is associated with an increased prevalence of pheochromocytoma and paraganglioma compared to the general population, 1.0%-5.7% versus 0.2%-0.6%, respectively. A delay in pheochromocytoma and paraganglioma diagnosis or undiagnosed pheochromocytoma and paraganglioma, as seen in normotensive and asymptomatic patients, may portend a significant morbidity and mortality risk due to excess catecholamine secretion. Currently, there are no generally accepted guidelines of screening for pheochromocytoma and paragangliomas in asymptomatic individuals of this population with approaches and practices varying considerably between physicians. Emerging data suggest benefit in routine pheochromocytoma and paraganglioma screening of all individuals with neurofibromatosis type 1. Herein, we present a case to highlight how routine case detection screening would have identified pheochromocytoma earlier in an active duty military member.
1型神经纤维瘤病是一种复杂的多系统遗传性疾病,与嗜铬细胞瘤和副神经节瘤的患病率增加有关,与普通人群相比,分别为1.0%-5.7%和0.2%-0.6%。在血压正常和无症状的患者中,嗜铬细胞瘤和副神经节瘤诊断延迟或未被诊断,可能因儿茶酚胺分泌过多而预示着显著的发病和死亡风险。目前,对于该人群无症状个体的嗜铬细胞瘤和副神经节瘤筛查,尚无普遍接受的指南,医生之间的方法和实践差异很大。新出现的数据表明,对所有1型神经纤维瘤病患者进行常规嗜铬细胞瘤和副神经节瘤筛查有益。在此,我们介绍一个病例,以强调常规病例检测筛查如何能在一名现役军人中更早地发现嗜铬细胞瘤。