Kailasam M T, Parmer R J, Stone R A, Shankel S, Kennedy B P, Ziegler M G, O'Connor D T
Department of Medicine, University of California, San Diego 92161, USA.
Am J Hypertens. 1995 Jun;8(6):651-5. doi: 10.1016/0895-7061(95)00076-2.
Factitious pheochromocytoma usually occurs in patients surreptitiously ingesting adrenergic medications. We encountered a case of factitious pheochromocytoma where in the subject mimicked hemodynamic (profound hypertension) and biochemical (plasma catecholamine elevation) manifestations of the illness by consciously altering autonomic function with Valsalva maneuver. Clues to this presentation included visible performance of Valsalva maneuver, marked disparity between blood pressures recorded in the presence and absence of the subject's knowledge, normal urinary catecholamine and metabolite excretion, and normal plasma chromogranin A. We reproduced, in part, the hemodynamic and biochemical manifestations of this presentation with Valsalva maneuver in healthy subjects.
假性嗜铬细胞瘤通常发生在偷偷服用肾上腺素能药物的患者身上。我们遇到了一例假性嗜铬细胞瘤病例，该患者通过瓦尔萨尔瓦动作有意识地改变自主神经功能，从而模拟了该疾病的血流动力学（严重高血压）和生化（血浆儿茶酚胺升高）表现。该病例的线索包括明显的瓦尔萨尔瓦动作、受试者知情和不知情时记录的血压之间存在显著差异、尿儿茶酚胺和代谢产物排泄正常以及血浆嗜铬粒蛋白A正常。我们通过在健康受试者身上进行瓦尔萨尔瓦动作，部分重现了该病例的血流动力学和生化表现。
