Kieler C, Helpap B, Dapp A
Dtsch Med Wochenschr. 1984 Dec 7;109(49):1885-9. doi: 10.1055/s-2008-1069473.
A 22-year-old woman was admitted to hospital in shock, the admission diagnosis being lobar pneumonia with septic shock. Ultrasound demonstrated a tumour in the region of the left adrenal, but because of the absence of hypertensive symptoms and hypoglycaemia this was interpreted as a non-contributory finding. Despite intensive therapeutic measures the patient died within a few hours. At autopsy a phaeochromocytoma of the left adrenal gland was found. "Catecholamine myocarditis" resulting in acute cardiac failure, was demonstrated histologically. Phaeochromocytoma with predominant adrenaline or dopamine secretions often takes a normotensive or hypotensive course. Sudden excessive catecholamine release can, as in the described case, cause so-called adrenaline shock. The catecholamine-induced hypoxic-toxic myocardial changes determine the likely outcome.
一名22岁女性因休克入院，入院诊断为大叶性肺炎伴感染性休克。超声显示左肾上腺区域有一个肿瘤，但由于没有高血压症状和低血糖，该肿瘤被认为与病情无关。尽管采取了强化治疗措施，患者仍在数小时内死亡。尸检发现左肾上腺嗜铬细胞瘤。组织学检查显示存在导致急性心力衰竭的“儿茶酚胺性心肌炎”。以肾上腺素或多巴胺分泌为主的嗜铬细胞瘤通常表现为血压正常或低血压病程。如本例所述，儿茶酚胺突然过度释放可导致所谓的肾上腺素休克。儿茶酚胺诱导的缺氧性毒性心肌改变决定了可能的预后。
