Taniguchi Hiroaki, Kiriu Nobuaki, Kato Hiroshi, Kiyozumi Tetsuro
Department of Traumatology and Critical Care Medicine National Defense Medical College Saitama Japan.
Acute Med Surg. 2023 Jun 13;10(1):e858. doi: 10.1002/ams2.858. eCollection 2023 Jan-Dec.
Pheochromocytoma crisis (PCC) is a fatal disease characterized by hyper and/or hypotension, hyperthermia, and encephalopathy, and its diagnosis and treatment are challenging.
A 50-year-old woman presented with hypertension, and computed tomography showed an adrenal tumor. Fever, shock, and impaired consciousness were observed, and PCC was diagnosed clinically. Systolic blood pressure fluctuated from 40-220 mmHg within a few minutes, and circulatory agonists were adjusted accordingly. The blood pressure changes gradually stabilized with α-blockade. Surgery was performed on hospital day 26, and the pathological diagnosis was consistent with a pheochromocytoma. She was discharged on hospital day 37.
Computed tomography may facilitate early diagnosis in the acute phase of PCC in case of limited patient medical information and insufficient time to wait for a definitive diagnosis using traditional hormone tests. The shock requires pharmacological therapy to maintain circulation, and paradoxically, the administration of α-blockade can be lifesaving.
嗜铬细胞瘤危象（PCC）是一种致命疾病，其特征为高血压和/或低血压、高热及脑病，其诊断和治疗具有挑战性。
一名50岁女性因高血压就诊，计算机断层扫描显示肾上腺肿瘤。观察到发热、休克及意识障碍，临床诊断为PCC。收缩压在几分钟内从40 - 220mmHg波动，相应调整循环激动剂。血压变化经α受体阻滞剂逐渐稳定。于住院第26天进行手术，病理诊断与嗜铬细胞瘤一致。患者于住院第37天出院。
在患者医疗信息有限且等待传统激素检测确诊时间不足的情况下，计算机断层扫描有助于嗜铬细胞瘤危象急性期的早期诊断。休克需要药物治疗以维持循环，矛盾的是，给予α受体阻滞剂可挽救生命。
