Adrenocorticotropic Hormone Secreting Pheochromocytoma Underlying Glucocorticoid Induced Pheochromocytoma Crisis
Context. Pheochromocytomas are hormone secreting tumors of the medulla of the adrenal glands found in 0.1–0.5% of patients with hypertension. The vast majority of pheochromocytomas secrete catecholamines, but they have been occasionally shown to also secrete interleukins, calcitonin, testosterone, a...
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2018-01-01
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Series: | Case Reports in Endocrinology |
Online Access: | http://dx.doi.org/10.1155/2018/3963274 |
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author | Gil A. Geva David J. Gross Haggi Mazeh Karine Atlan Iddo Z. Ben-Dov Matan Fischer |
author_facet | Gil A. Geva David J. Gross Haggi Mazeh Karine Atlan Iddo Z. Ben-Dov Matan Fischer |
author_sort | Gil A. Geva |
collection | DOAJ |
description | Context. Pheochromocytomas are hormone secreting tumors of the medulla of the adrenal glands found in 0.1–0.5% of patients with hypertension. The vast majority of pheochromocytomas secrete catecholamines, but they have been occasionally shown to also secrete interleukins, calcitonin, testosterone, and in rare cases adrenocorticotropic hormone. Pheochromocytoma crisis is a life threatening event in which high levels of catecholamines cause a systemic reaction leading to organ failure. Case Description. A 70-year-old man was admitted with acute myocardial ischemia following glucocorticoid administration as part of an endocrine workup for an adrenal mass. Cardiac catheterization disclosed patent coronary arteries and he was discharged. A year later he returned with similar angina-like chest pain. During hospitalization, he suffered additional events of chest pain, shortness of breath, and palpitations following administration of glucocorticoids as preparation for intravenous contrast administration. Throughout his admission, the patient demonstrated both signs of Cushing’s syndrome and high catecholamine levels. Following stabilization of vital parameters and serum electrolytes, the adrenal mass was resected surgically and was found to harbor an adrenocorticotropic hormone secreting pheochromocytoma. This is the first documented case of adrenocorticotropic hormone secreting pheochromocytoma complicated by glucocorticoid induced pheochromocytoma crisis. Conclusion. Care should be taken when administering high doses of glucocorticoids to patients with suspected pheochromocytoma, even in a patient with concomitant Cushing’s syndrome. |
format | Article |
id | doaj-art-05a760c95ef34830b35064cb7f15f4a5 |
institution | Kabale University |
issn | 2090-6501 2090-651X |
language | English |
publishDate | 2018-01-01 |
publisher | Wiley |
record_format | Article |
series | Case Reports in Endocrinology |
spelling | doaj-art-05a760c95ef34830b35064cb7f15f4a52025-02-03T05:44:11ZengWileyCase Reports in Endocrinology2090-65012090-651X2018-01-01201810.1155/2018/39632743963274Adrenocorticotropic Hormone Secreting Pheochromocytoma Underlying Glucocorticoid Induced Pheochromocytoma CrisisGil A. Geva0David J. Gross1Haggi Mazeh2Karine Atlan3Iddo Z. Ben-Dov4Matan Fischer5The Hebrew University Hadassah Medical School, Hadassah-Hebrew University Medical Center, Jerusalem, IsraelEndocrinology & Metabolism Service, Hadassah-Hebrew University Medical Center, Jerusalem, IsraelDepartment of General Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, IsraelDepartment of Pathology, Hadassah-Hebrew University Medical Center, Jerusalem, IsraelNephrology and Hypertension Services, Hadassah-Hebrew University Medical Center, Jerusalem, IsraelDepartment of Internal Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, IsraelContext. Pheochromocytomas are hormone secreting tumors of the medulla of the adrenal glands found in 0.1–0.5% of patients with hypertension. The vast majority of pheochromocytomas secrete catecholamines, but they have been occasionally shown to also secrete interleukins, calcitonin, testosterone, and in rare cases adrenocorticotropic hormone. Pheochromocytoma crisis is a life threatening event in which high levels of catecholamines cause a systemic reaction leading to organ failure. Case Description. A 70-year-old man was admitted with acute myocardial ischemia following glucocorticoid administration as part of an endocrine workup for an adrenal mass. Cardiac catheterization disclosed patent coronary arteries and he was discharged. A year later he returned with similar angina-like chest pain. During hospitalization, he suffered additional events of chest pain, shortness of breath, and palpitations following administration of glucocorticoids as preparation for intravenous contrast administration. Throughout his admission, the patient demonstrated both signs of Cushing’s syndrome and high catecholamine levels. Following stabilization of vital parameters and serum electrolytes, the adrenal mass was resected surgically and was found to harbor an adrenocorticotropic hormone secreting pheochromocytoma. This is the first documented case of adrenocorticotropic hormone secreting pheochromocytoma complicated by glucocorticoid induced pheochromocytoma crisis. Conclusion. Care should be taken when administering high doses of glucocorticoids to patients with suspected pheochromocytoma, even in a patient with concomitant Cushing’s syndrome.http://dx.doi.org/10.1155/2018/3963274 |
spellingShingle | Gil A. Geva David J. Gross Haggi Mazeh Karine Atlan Iddo Z. Ben-Dov Matan Fischer Adrenocorticotropic Hormone Secreting Pheochromocytoma Underlying Glucocorticoid Induced Pheochromocytoma Crisis Case Reports in Endocrinology |
title | Adrenocorticotropic Hormone Secreting Pheochromocytoma Underlying Glucocorticoid Induced Pheochromocytoma Crisis |
title_full | Adrenocorticotropic Hormone Secreting Pheochromocytoma Underlying Glucocorticoid Induced Pheochromocytoma Crisis |
title_fullStr | Adrenocorticotropic Hormone Secreting Pheochromocytoma Underlying Glucocorticoid Induced Pheochromocytoma Crisis |
title_full_unstemmed | Adrenocorticotropic Hormone Secreting Pheochromocytoma Underlying Glucocorticoid Induced Pheochromocytoma Crisis |
title_short | Adrenocorticotropic Hormone Secreting Pheochromocytoma Underlying Glucocorticoid Induced Pheochromocytoma Crisis |
title_sort | adrenocorticotropic hormone secreting pheochromocytoma underlying glucocorticoid induced pheochromocytoma crisis |
url | http://dx.doi.org/10.1155/2018/3963274 |
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