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[嗜铬细胞瘤误诊为肥厚型心肌病]

[A false diagnosis of hypertrophic myocardiopathy in pheochromocytoma].

作者信息

Lopes H F, Silva H B, Frimm C de C, Bortolotto L A, Belotti G, Pileggi F

机构信息

Instituto do Coração do Hospital das Clínicas - FMUSP.

出版信息

Arq Bras Cardiol. 1995 Aug;65(2):167-9.

PMID:8554495
Abstract

A 24 year-old man was admitted with hypertensive crises and diagnosis hypothesis of neurofibromathosis and pheochromocytoma with blood pressure of 150 x 110mmHg and in use of anti-hypertensive drugs. The electrocardiogram (EKG) showed left ventricle hypertrophy. An echocardiogram showed interventricular septum (IVS) thickness of 16mm, posterior wall (PW) thickness of 11mm (ratio IVS/PW was 1.4). Diastolic ventricular diameter was 39mm with gradient of 52mmHg and mild mitral-valve murmur by pulsate Doppler. Increased vanillylmandelic acid and metanephrines in a 24-hour sample of urine has confirmed diagnosis of pheochromocytoma within was localized by 131I metaiodobenzyl-guanidine scan and computerized axial tomography. The patient was submitted to right adrenalectomy. Blood pressure was normalized. Evaluation an year later revealed a healthy man with normal laboratory exams, EKG and echocardiogram. It seems that the hypertrophy was consequence of the hypertension and pheochromocytoma, was not hypertrophic cardiomyopathy.

摘要

一名24岁男性因高血压危象入院,诊断假设为神经纤维瘤病和嗜铬细胞瘤,血压为150×110mmHg,正在使用抗高血压药物。心电图(EKG)显示左心室肥厚。超声心动图显示室间隔(IVS)厚度为16mm,后壁(PW)厚度为11mm(IVS/PW比值为1.4)。舒张期心室直径为39mm,压差为52mmHg,脉冲多普勒显示轻度二尖瓣杂音。24小时尿样中香草扁桃酸和甲氧基肾上腺素增加,证实了嗜铬细胞瘤的诊断,通过131I间碘苄胍扫描和计算机断层扫描定位。患者接受了右肾上腺切除术。血压恢复正常。一年后的评估显示该男子健康,实验室检查、心电图和超声心动图均正常。看来这种肥厚是高血压和嗜铬细胞瘤的结果,而非肥厚型心肌病。

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