Koizumi Go, Saiki Ryo, Kurokawa Ippei, Mikura Kentaro, Iida Tatsuya, Murai Norimitsu, Kaji Mariko, Hashizume Mai, Kigawa Yasuyoshi, Endo Kei, Iizaka Toru, Otsuka Fumiko, Isobe Tomohide, Norose Tomoko, Ohike Nobuyuki, Sasaki Jun, Hayashi Munetaka, Sasaki Haruaki, Nagasaka Shoichiro
Division of Diabetes, Metabolism and Endocrinology, Showa University Fujigaoka Hospital, Japan.
Division of Urology, Showa University Fujigaoka Hospital, Japan.
Intern Med. 2019 Nov 1;58(21):3113-3119. doi: 10.2169/internalmedicine.2991-19. Epub 2019 Jul 10.
A 38-year-old woman who consulted a local doctor with chief complaints of sudden palpitations, headaches, and chest pain is herein presented. After admission, pheochromocytoma crisis was suspected. Since the patient had a history of acute heart failure and had once survived an episode of cardiac arrest, a rapid decrease in the catecholamine levels was needed. After resuscitation, pharmacological therapy with agents such as phentolamine and landiolol was administered, and continuous hemodiafiltration (CHDF) was performed to reduce the catecholamine levels. Elective surgery was then performed, and a positive outcome was achieved. This case suggests that the preoperative use of CHDF to control pheochromocytoma crisis may therefore be effective.
本文介绍了一名38岁女性,她因突发心悸、头痛和胸痛前往当地医生处就诊。入院后,怀疑为嗜铬细胞瘤危象。由于该患者有急性心力衰竭病史,曾有过一次心脏骤停并存活下来,因此需要迅速降低儿茶酚胺水平。复苏后,给予酚妥拉明和兰地洛尔等药物进行药理治疗,并进行持续血液透析滤过(CHDF)以降低儿茶酚胺水平。随后进行了择期手术,并取得了良好的效果。该病例表明,术前使用CHDF控制嗜铬细胞瘤危象可能是有效的。