Document Detail


Pheochromocytoma complicated with severe ventricular tachycardia: report of one case.
MedLine Citation:
PMID:  18254579     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Pheochromocytoma in children shows much worse complications than that in the adult patients. An 11-year-old girl was transferred to our emergency room after suffering from headache, dizziness, cold sweating and palpitation for 3 days. Severe hypertension, remarkable blood pressure fluctuation between 260/160 and 65/50 mmHg, decrease of cardiac contractility, as well as abnormal electrocardiogram findings including ST-T segment elevation and QT interval prolongation were noted soon after admission. Later, a 4x4.5x2.5 cm tumor in the right adrenal gland area was found by computed axial tomogram study. Assessment of the urine catecholamine metabolites showed high levels of vanillylmandelic acid, normetanephrine and norepinephrine indicating an active adrenal pheochromocytoma produced mainly norepinephrine. Although several antihypertensive drugs were used, ventricular tachycardia and Torsade de pointe still occurred on her for 3 times, each was preceded by a period of blood pressure fluctuation and burst out concomitantly at the peak of a hypertension crisis. From this case, we found that when the specific alpha-blocker like phenoxybenzamine or phentolamine was not available to us, labetalol by continuous intravenous infusion was the only effective drug to protect the patient from attacks of hypertensive crisis and ventricular tachycardia. Her right adrenal gland was resected smoothly when BP was well under control. Histological examination showed the adrenal medulla was full of pheochromocytoma cells.
Authors:
Yu-Chih Huang; Chao-Hsiang Chang; Chung-Hsing Wang; Jeng-Sheng Chang
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Acta paediatrica Taiwanica = Taiwan er ke yi xue hui za zhi     Volume:  48     ISSN:  1608-8115     ISO Abbreviation:  Acta Paediatr Taiwan     Publication Date:    2007 Sep-Oct
Date Detail:
Created Date:  2008-02-07     Completed Date:  2008-02-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100958202     Medline TA:  Acta Paediatr Taiwan     Country:  China (Republic : 1949- )    
Other Details:
Languages:  eng     Pagination:  280-4     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, China Medical University Hospital, Taichung, Taiwan.
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MeSH Terms
Descriptor/Qualifier:
Adrenal Gland Neoplasms / complications*
Child
Electrocardiography
Female
Humans
Pheochromocytoma / complications*
Tachycardia, Ventricular / etiology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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