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未检测出的嗜铬细胞瘤中儿茶酚胺诱导的心肌炎。

Catecholamine-Induced Myocarditis in Undetected Pheochromocytoma.

作者信息

Hassan Narmeen, Goh Jing W, Hassan Usman

机构信息

Internal Medicine, Countess of Chester Hospital, Chester, GBR.

Respiratory Medicine, Countess of Chester Hospital, Chester, GBR.

出版信息

Cureus. 2025 Jun 10;17(6):e85720. doi: 10.7759/cureus.85720. eCollection 2025 Jun.

Abstract

Pheochromocytoma is a neuroendocrine tumor of the adrenal gland. It can cause a range of symptoms, but the main ones are palpitations, pallor, headaches, and sweating. Due to its rarity and episodic character, it is frequently misdiagnosed in the initial instance. We report the case of a young woman in her twenties who was misdiagnosed with hypotension, headache, cough, and palpitations, and an echocardiography revealed reduced cardiac function. She was initially diagnosed with Takotsubo cardiomyopathy and then with myocarditis based on clinical and radiological findings, and she was treated for cardiogenic shock. She continued to have a headache, which was diagnosed as a cardiac cephalalgia. Despite receiving topiramate and analgesia, she continued to have headaches and hypotension. She was found to have periodic episodes of hypertension, prompting a pheochromocytoma screening. She had a successful adrenalectomy and recovered well. This case report emphasizes the significance of having a high degree of suspicion for pheochromocytoma in individuals presenting with unexplained cardiac dysfunction.

摘要

嗜铬细胞瘤是肾上腺的一种神经内分泌肿瘤。它可引起一系列症状,但主要症状为心悸、面色苍白、头痛和出汗。由于其罕见性和发作性特点,在初始阶段常常被误诊。我们报告了一例二十多岁年轻女性的病例,她最初被误诊为低血压、头痛、咳嗽和心悸,超声心动图显示心脏功能下降。最初她被诊断为应激性心肌病,随后根据临床和影像学检查结果被诊断为心肌炎,并接受了心源性休克的治疗。她持续头痛,被诊断为心源性头痛。尽管服用了托吡酯并进行了止痛治疗,她仍持续头痛和低血压。后来发现她有周期性高血压发作,于是进行了嗜铬细胞瘤筛查。她成功接受了肾上腺切除术,恢复良好。本病例报告强调了对于出现不明原因心脏功能障碍的个体高度怀疑嗜铬细胞瘤的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a935/12245142/8b183e03a640/cureus-0017-00000085720-i01.jpg

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