Kim H J, Kim D K, Lee S C, Yang S H, Yang J H, Lee W R
Department of Medicine, Samsung Medical Center, SungKyunKwan University College of Medicine, Seoul, Korea.
Korean J Intern Med. 1998 Jul;13(2):117-22. doi: 10.3904/kjim.1998.13.2.117.
Pheochromocytoma in pregnancy is very rare but it is associated with very high maternal and fetal mortality. Therefore, it is important to include pheochromocytoma in the differential diagnosis of hypertension associated with pregnancy. It is difficult to make a diagnosis of pheochromocytoma in pregnancy before delivery. The characteristic symptoms of pheochromocytoma could be initiated during delivery because the process of delivery, general anesthesia, fetal movement, induce acute surge of catecholamine release, which could also induce cardiomyopathy. Early diagnosis and intensive care can affect the prognosis of cardiomyopathy induced by pheochromocytoma. Proper management with alpha-blockade, beta-blockade and angiotension converting enzyme inhibitor could acutely reverse the course of cardiomyopathy.
妊娠期嗜铬细胞瘤非常罕见，但与极高的母婴死亡率相关。因此，在妊娠相关高血压的鉴别诊断中纳入嗜铬细胞瘤很重要。分娩前很难诊断妊娠期嗜铬细胞瘤。嗜铬细胞瘤的典型症状可能在分娩过程中出现，因为分娩过程、全身麻醉、胎儿活动会诱发儿茶酚胺释放急性激增，这也可能诱发心肌病。早期诊断和重症监护会影响嗜铬细胞瘤所致心肌病的预后。使用α受体阻滞剂、β受体阻滞剂和血管紧张素转换酶抑制剂进行恰当治疗可迅速逆转心肌病病程。
