Document Detail


Pseudopheochromocytoma of pregnancy.
MedLine Citation:
PMID:  14583419     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To report a diagnostically challenging case of preeclampsia. METHODS: We present a case report with clinical, biochemical, imaging, and immunohistochemical findings. In addition, the clinical features of pheochromocytoma during pregnancy are reviewed, and the challenges in distinguishing it from preeclampsia are discussed. RESULTS: A 33-year-old woman presented at 14 weeks' gestational age with severe hypertension. Evaluation for secondary causes of hypertension were prompted by difficulty controlling the blood pressure and associated symptoms of headache and nausea. Investigations revealed high levels of urinary catecholamines, in conjunction with increased uptake of (111)In-labeled octreotide in the midabdominal area. At 28 weeks' gestation, worsening of blood pressure, high liver enzyme levels, and proteinuria necessitated a cesarean delivery and concomitant hysterectomy. Blood pressure and urinary catecholamine excretion promptly normalized after delivery. Pathologic examination of the uterus and placenta demonstrated no expression of neuroendocrine markers including chromogranin, but the trophoblast demonstrated strong immunostaining for tyrosine hydroxylase. Expression of this rate-limiting enzyme responsible for catecholamine synthesis may have contributed to the pathogenesis of preeclampsia in this patient. CONCLUSION: This case demonstrates that severe pre-eclampsia may mimic pheochromocytoma.
Authors:
Baiju R Shah; Shital Gandhi; Sylvia L Asa; Shereen Ezzat
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists     Volume:  9     ISSN:  1530-891X     ISO Abbreviation:  Endocr Pract     Publication Date:    2003 Sep-Oct
Date Detail:
Created Date:  2003-10-29     Completed Date:  2004-04-06     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9607439     Medline TA:  Endocr Pract     Country:  United States    
Other Details:
Languages:  eng     Pagination:  376-9     Citation Subset:  IM    
Affiliation:
Department of Medicine, University of Toronto, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Adrenal Gland Neoplasms / radionuclide imaging*
Adult
Diagnosis, Differential
Female
Humans
Hypertension / radionuclide imaging
Pheochromocytoma / radionuclide imaging*
Pre-Eclampsia / radionuclide imaging*
Pregnancy
Comments/Corrections
Comment In:
Endocr Pract. 2004 Jul-Aug;10(4):382; author reply 382-3   [PMID:  15776524 ]

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


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