Document Detail

Cardiorespiratory crisis at the end of pregnancy: a case of pheochromocytoma.
MedLine Citation:
PMID:  24180171     Owner:  NLM     Status:  MEDLINE    
Pheochromocytoma during pregnancy is extremely rare. Its clinical manifestation includes hypertension with various clinical presentations, possibly resembling those of pregnancy-induced hypertension. The real challenge for clinicians is differentiating pheochromocytoma from other causes of hypertension (preeclampsia, gestational hypertension, and pre-existing or essential hypertension), from other cause of pulmonary edema (preeclampsia, peripartum cardiomyopathy, stress or Takotsubo cardiomyopathy, pre-existing cardiac disease [mitral stenosis], and high doses betamimetics), and from other causes of cardiovascular collapse (pulmonary embolism, and amniotic fluid embolism). Although, several cases of pheochromocytoma during pregnancy have been published, fetal and maternal mortalities due to undiagnosed cases are still reported. We report a case of a patient whose delivery by cesarean section was complicated by severe hemodynamic instability resulting in a cardiac arrest. Later on, pheochromocytoma was suspected based on computed tomography (CT) scan findings. Diagnosis was confirmed with special biochemical investigations that showed markedly elevated catecholamines in urine and metanephrines in serum, and later by histopathology of the excised left adrenal mass. This case illustrates the difficulty of diagnosing pheochromocytoma in pregnancy and raises the awareness to when this rare disease should be suspected.
Samir Haddad; Basel Al-Raiy; Azza Madkhali; Saad Al-Qahtani; Mohammad Al-Sultan; Yaseen Arabi
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Middle East journal of anaesthesiology     Volume:  22     ISSN:  0544-0440     ISO Abbreviation:  Middle East J Anaesthesiol     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-11-04     Completed Date:  2013-11-19     Revised Date:  2014-10-10    
Medline Journal Info:
Nlm Unique ID:  8604187     Medline TA:  Middle East J Anaesthesiol     Country:  Lebanon    
Other Details:
Languages:  eng     Pagination:  195-202     Citation Subset:  IM    
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MeSH Terms
Adrenal Gland Neoplasms / diagnosis*,  surgery
Cardiopulmonary Resuscitation / methods
Catecholamines / urine
Cesarean Section
Diagnosis, Differential
Heart Arrest / etiology*,  therapy
Metanephrine / blood
Pheochromocytoma / complications,  diagnosis*,  surgery
Pregnancy Complications, Neoplastic / diagnosis*,  surgery
Pregnancy Trimester, Third
Tomography, X-Ray Computed / methods
Reg. No./Substance:
0/Catecholamines; 5001-33-2/Metanephrine

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