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嗜铬细胞瘤的临床表现及筛查建议。

Clinical presentation of pheochromocytoma and screening recommendations.

作者信息

Arroyo Ripoll O F, Achote E, Araujo-Castro M

机构信息

Servicio de Endocrinología Clínica y Metabolismo, Universidad de Antioquia, Medellín, Colombia.

Servicio de Endocrinología y Nutrición, Hospital Universitario Ramón y Cajal, Madrid, Spain.

出版信息

Rev Clin Esp (Barc). 2025 Mar;225(3):157-167. doi: 10.1016/j.rceng.2025.01.004. Epub 2025 Jan 23.

Abstract

Pheochromocytomas are neuroendocrine tumors that derive from sympathetic adrenomedullary chromaffin tissue and produce catecholamines. Due to the excess release of catecholamines, they can produce arterial hypertension, tachycardia, sweating, headache and a large number of other clinical manifestations secondary to the stimulation of α and β adrenoreceptors. Screening for pheochromocytoma is recommended in patients with paroxysmal, resistant or early-onset arterial hypertension, in cases with symptoms suggestive of catecholamine hypersecretion, patients with hereditary syndromes associated with pheochromocytomas, diabetes mellitus of atypical presentation and in adrenal incidentalomas with radiological characteristics not typical of adenoma (with > 10 Hounsfield Units on non-contrast CT). In this article we present an exhaustive review of the clinical data and complications that can be associated with pheochromocytomas, and we summarize the main indications for pheochromocytoma screening.

摘要

嗜铬细胞瘤是起源于交感肾上腺髓质嗜铬组织并分泌儿茶酚胺的神经内分泌肿瘤。由于儿茶酚胺过度释放,它们可导致动脉高血压、心动过速、出汗、头痛以及大量继发于α和β肾上腺素能受体刺激的其他临床表现。对于阵发性、难治性或早发性动脉高血压患者、有儿茶酚胺分泌过多症状的患者、与嗜铬细胞瘤相关的遗传性综合征患者、非典型表现的糖尿病患者以及具有非典型腺瘤放射学特征(非增强CT上>10亨氏单位)的肾上腺意外瘤患者,建议进行嗜铬细胞瘤筛查。在本文中,我们对可能与嗜铬细胞瘤相关的临床数据和并发症进行了详尽综述,并总结了嗜铬细胞瘤筛查的主要指征。

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