Konishi Seigo, Kometani Mitsuhiro, Aiga Ko, Aono Daisuke, Nohara Takahiro, Ikeda Hiroko, Karashima Shigehiro, Takeda Yoshiyu, Yoneda Takashi
Department of Health Promotion and Medicine of the Future, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan.
Integrative Cancer Therapy and Urology, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa, Japan.
Endocrinol Diabetes Metab Case Rep. 2023 Jul 4;2023(3):23-0033. doi: 10.1530/EDM-23-0033.
The COVID-19 pandemic has led to the emergence of telemedicine on a global scale. In endocrinology, telemedicine has mainly been used in relation to chronic diseases, including diabetes. Herein, we report the case of an 18-year-old woman with a hypertensive emergency due to a pheochromocytoma who was quickly diagnosed and treated using telemedicine. The patient was referred to a cardiovascular hospital because of fatigue and sweating that did not improve with carvedilol. She had fluctuating blood pressure and tachycardia. Subsequently, since her thyroid function was normal, endocrine hypertension not due to thyroid dysfunction was suspected; a case consultation was made by phone to our clinic. Plain computed tomography (CT) was recommended owing to the high possibility of a pheochromocytoma; the CT scan showed an adrenal tumor with a 30 mm diameter. To assess her condition, endocrinologists, together with the attending doctor, interviewed her and her family directly using an online tool to obtain detailed information. We thus determined that she was at risk of a pheochromocytoma crisis. She was transferred to our hospital immediately for treatment, was diagnosed with pheochromocytoma, and underwent surgery. Telemedicine, especially involving doctor-to-patient with doctor consultations, can be effective in treating rare and emergent medical conditions such as pheochromocytoma crisis.
Telemedicine can be used for chronic diseases and emergency conditions. Online doctor-to-patient with doctor (D-to-P with D) consultations are useful when the expert opinion of a highly specialized physician present in a different geographical location is required. Telemedicine, especially D-to-P with D online consultations, can be effectively used for the diagnosis of rare and emergent medical conditions, such as pheochromocytoma crisis.
新冠疫情促使远程医疗在全球范围内兴起。在内分泌学领域，远程医疗主要应用于包括糖尿病在内的慢性病。在此，我们报告一例18岁因嗜铬细胞瘤引发高血压急症的女性病例，该病例通过远程医疗迅速得到诊断和治疗。患者因服用卡维地洛后疲劳和出汗症状未改善，被转诊至一家心血管医院。她血压波动且心动过速。随后，由于其甲状腺功能正常，怀疑为非甲状腺功能障碍所致的内分泌性高血压；遂通过电话向我们诊所进行了病例咨询。鉴于嗜铬细胞瘤可能性高，建议进行普通计算机断层扫描（CT）；CT扫描显示一个直径30毫米的肾上腺肿瘤。为评估其病情，内分泌科医生与主治医生一起通过在线工具直接询问患者及其家属以获取详细信息。由此我们确定她有嗜铬细胞瘤危象风险。她立即被转至我院接受治疗，被诊断为嗜铬细胞瘤并接受了手术。远程医疗，尤其是涉及医生与患者及医生会诊的模式，对于治疗诸如嗜铬细胞瘤危象等罕见和紧急病症可能有效。
远程医疗可用于慢性病和急症。当需要不同地理位置的高度专科医生的专家意见时，在线医生与患者及医生会诊（D-to-P with D）很有用。远程医疗，尤其是D-to-P with D在线会诊，可有效用于诊断罕见和紧急病症，如嗜铬细胞瘤危象。
