Bartikoski Stephanie R, Reschke Daniel J
Emergency Medicine, San Antonio Military Medical Center, San Antonio, USA.
Cureus. 2021 Mar 3;13(3):e13683. doi: 10.7759/cureus.13683.
Pheochromocytoma is a rare, often undiagnosed adrenal tumor that typically presents in early adulthood and is characterized by intermittent surges of catecholamines. While this "Great Mimic" may present with a variety of vague complaints such as headache, abdominal pain, or palpitations, it may also appear as a severely hypertensive patient with multi-organ failure and cardiopulmonary collapse known as pheochromocytoma crisis. Management of hypertensive emergency in these patients is unique, and the associated metabolic derangements, coagulopathy, thromboembolic events, and risk of adrenal capsule rupture add significant complexity, morbidity, and mortality to these cases. Emergency providers should learn when to suspect this uncommon but life-threatening diagnosis in order to properly manage these potentially critically ill patients.
嗜铬细胞瘤是一种罕见的、常常未被诊断出的肾上腺肿瘤，通常在成年早期出现，其特征是儿茶酚胺间歇性激增。虽然这个“伟大的模仿者”可能会出现各种模糊的症状，如头痛、腹痛或心悸，但它也可能表现为患有多器官功能衰竭和心肺功能衰竭的严重高血压患者，即嗜铬细胞瘤危象。这些患者高血压急症的管理具有独特性，并且相关的代谢紊乱、凝血障碍、血栓栓塞事件以及肾上腺包膜破裂的风险增加了这些病例的显著复杂性、发病率和死亡率。急救人员应该了解何时怀疑这种罕见但危及生命的诊断，以便妥善处理这些潜在的重症患者。
