아나필락시스쇼크로 오인된 기능성 부신경절종 -증례 보고-
A Case of Functioning Paraganglioma Mimicking Anaphylactic Shock -A Case Report-
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초록
Paraganglioma is a tumor originating from the extra-adrenal chromaffin cells, and functional paraganglioma causes paroxysmal hypertension, headache and tachycardia, due to excess excretion of catecholamine. However, rarely, ARDS, acute myocardial infarction, heart failure, arrhythmia, and pulmonary edema are also seen in patients with paraganglioma and clinical manifestations are depending on the patient’s intravascular volume status. Seventy one-years-old male was presented with hypotension and pulmonary edema after intravenous midazolam injection during colonoscopy under conscious sedation. The patient was initially suspected with anaphylactic shock, due to midazolam injection. However, later, he was diagnosed with paraganglioma, and blood pressure was successfully controlled with alpha adrenergic blockade. We suggest that when we encounter heart failure, pulmonary edema and shock of unknown origin, pheochromocytoma must be taken into consideration.
Abstract
Paraganglioma is a tumor originating from the extra-adrenal chromaffin cells, and functional paraganglioma causes paroxysmal hypertension, headache and tachycardia, due to excess excretion of catecholamine. However, rarely, ARDS, acute myocardial infarction, heart failure, arrhythmia, and pulmonary edema are also seen in patients with paraganglioma and clinical manifestations are depending on the patient’s intravascular volume status. Seventy one-years-old male was presented with hypotension and pulmonary edema after intravenous midazolam injection during colonoscopy under conscious sedation. The patient was initially suspected with anaphylactic shock, due to midazolam injection. However, later, he was diagnosed with paraganglioma, and blood pressure was successfully controlled with alpha adrenergic blockade. We suggest that when we encounter heart failure, pulmonary edema and shock of unknown origin, pheochromocytoma must be taken into consideration.
참고문헌 (8)
- Prejbisz A, "Cardiovascular manifestations of phaeochromocytoma", J Hypertens, 29, pp.2049~2060 (2011)
- Plouin PF, "Pheochromocytomas and secreting paragangliomas", Orphanet J Rare Dis, 1, pp.49~ (2006)
- Fung MM, "Diseases of the adrenal medulla", Acta Physiol (Oxf), 192, pp.325~335 (2008)
- Zelinka T, "High incidence of cardiovascular complications in pheochromocytoma", Horm Metab Res, 44, pp.379~384 (2012)
- Olkkola KT, "Midazolam and other benzodiazepines", Handb Exp Pharmacol, (182), pp.335~360 (2008)
- Kassim TA, "Catecholamine-induced cardiomyopathy", Endocr Pract, 14, pp.1137~1149 (2008)
- Takagi S, "Dexamethasone-induced cardiogenic shock rescued by percutaneous cardiopulmonary support (PCPS) in a patient with pheochromocytoma", Jpn Circ J, 64, pp.785~788 (2000)
- Sardesai SH, "Phaeochromocytoma and catecholamine induced cardiomyopathy presenting as heart failure", Br Heart J, 63, pp.234~237 (1990)