Kihara H, Terai H, Kihara Y, Kihara T, Takahashi H, Kosuda A, Shimomoto M, Fukunishi M, Tanaka T
Department of Internal Medicine, Kihara Cardiovascular Clinic, Asahikawa.
J Cardiol. 1997 Jul;30(1):37-44.
A 54-year-old woman developed torsade de pointes with secondary QT prolongation due to hypokalemia and hypomagnesemia. Her serum K and Mg levels were 2.5 mEq/l and 1.5 mg/dl, respectively. This electrolyte imbalance was due to intentional overdosing of metolazone. Attacks of torsade de pointes occurred three times in the intensive care unit and were corrected by intravenous lidocaine administration. Her serum K level was corrected using KCl infusion, restoring the normal QT interval. Routine computed tomography found a left retroperitoneal paraganglioma. Urinary and serum catecholamine examination revealed extremely high values of epinephrine and norepinephrine. The diagnosis was pheochromocytoma in the left retroperitoneal paraganglion. The tumor which was removed measured 70 x 65 x 60 mm in size. Microscopic examination revealed the characteristic patterns of pheochromocytoma.
一名54岁女性因低钾血症和低镁血症发生尖端扭转型室速并伴有继发性QT间期延长。她的血清钾和镁水平分别为2.5 mEq/L和1.5 mg/dl。这种电解质失衡是由于故意过量服用美托拉宗所致。在重症监护病房发生了3次尖端扭转型室速发作,通过静脉注射利多卡因得以纠正。通过输注氯化钾纠正了她的血清钾水平,QT间期恢复正常。常规计算机断层扫描发现左腹膜后副神经节瘤。尿和血清儿茶酚胺检查显示肾上腺素和去甲肾上腺素值极高。诊断为左腹膜后副神经节嗜铬细胞瘤。切除的肿瘤大小为70×65×60 mm。显微镜检查显示出嗜铬细胞瘤的特征性形态。