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一例误诊为暴发性心肌炎的嗜铬细胞瘤病例报告——诊断挑战

A case report on pheochromocytoma mimicking as fulminant myocarditis-a diagnostic challenge.

作者信息

Cheng Yanwei, Ding Ning, Wang Longan, Qin Lijie

机构信息

Department of Emergency, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, China.

出版信息

Front Cardiovasc Med. 2024 Mar 27;11:1326608. doi: 10.3389/fcvm.2024.1326608. eCollection 2024.

Abstract

We present an exceptional case of a 53-year-old female, initially misdiagnosed with fulminant myocarditis, but later correctly diagnosed with pheochromocytoma. The presentation of the patient included a spectrum of symptoms such as headache, chest discomfort, palpitations, and dyspnea, following the intake of Domperidone. Two weeks prior to admission, the patient had experienced episodes of diarrhea and a low-grade fever. Unresolved symptoms and an unmanageable surge in blood pressure despite comprehensive fulminant myocarditis treatment prompted further investigation. The discovery of an adrenal mass via a CT scan and subsequent biochemical tests led to the confirmation of pheochromocytoma. Implementation of alpha-blockade therapy and a successful laparoscopic adrenalectomy resulted in significant clinical improvement. This case underscores the diagnostic intricacies of pheochromocytoma and highlights the need for vigilance when faced with severe, unresponsive cardiovascular symptoms.

摘要

我们报告了一例特殊病例,一名53岁女性,最初被误诊为暴发性心肌炎,但后来被正确诊断为嗜铬细胞瘤。患者在服用多潘立酮后出现了一系列症状,如头痛、胸部不适、心悸和呼吸困难。入院前两周,患者出现腹泻和低热。尽管对暴发性心肌炎进行了全面治疗,但症状仍未缓解,血压急剧上升且难以控制,促使进一步检查。通过CT扫描发现肾上腺肿块,随后的生化检查证实为嗜铬细胞瘤。实施α-阻断疗法并成功进行腹腔镜肾上腺切除术,使临床症状得到显著改善。该病例强调了嗜铬细胞瘤诊断的复杂性,并突出了面对严重、无反应的心血管症状时保持警惕的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17be/11004423/1c3a0145321e/fcvm-11-1326608-g001.jpg

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