Sabriá M, Cuevas J, Tallada N, Plans C, Rey C, Bernet M, Cabré J, Sánchez A
Med Clin (Barc). 1979 Nov 25;73(9):371-3.
Five cases of pheochromocytoma are described in which sudden death was the form of the initial clinical presentation in almost all of them. After a brief review on the history and the incidence of the tumor within the general population, diverse cases are analyzed from a clinical point of view and in relation to the data appeared in the literature. In the analysis of the symptoms emphasis is placed on the important psychomotor manifestations which are present in the majority of those patients and which causes serious difficulties in the initial diagnosis. All of the patients showed signs of shock at the time of being observed or during the course of this observation, and in the majority of them the presence of acute pulmonary edema was confirmed; facts which we attribute to an initial hypertensive episode associated to a left heart failure. The onset of the crisis in two patients was related to known triggering factors: anesthesia and sulpiride. In other two patients associated conditions were diagnosed: medullary carcinoma of the thyroid gland in one of them, and cystic necrosis of the middle layer of the aorta in the other.
本文描述了5例嗜铬细胞瘤病例,几乎所有病例的首发临床表现均为猝死。在简要回顾该肿瘤的病史及在普通人群中的发病率后,从临床角度并结合文献数据对不同病例进行了分析。在症状分析中,重点关注了大多数患者出现的重要精神运动表现,这些表现给初步诊断带来了严重困难。所有患者在观察时或观察过程中均出现休克迹象,且大多数患者确诊存在急性肺水肿;我们将这些情况归因于与左心衰竭相关的初始高血压发作。2例患者的危象发作与已知触发因素有关:麻醉和舒必利。另外2例患者诊断出相关疾病:其中1例为甲状腺髓样癌,另1例为主动脉中层囊性坏死。