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Delayed diagnosis of pheochromocytoma associated with chronic kidney disease.

Fernandes GH, Silva Júnior GB, Garcia JH, Sobrinho CR, Albuquerque PL, Libório AB, Daher EF - Indian J Nephrol (2010)

Bottom Line: Pheochromocytoma is a rare disease charactrized by excessive production of catecholamines, manifestating mainly with hypertension.An abdominal ultrasound was suggestive of chronic kidney disease (CKD).An abdominal computed tomography and magnetic resonance was performed and showed a mass in the topography of left adrenal.

View Article: PubMed Central - PubMed

Affiliation: Divisions of Nephrology and Cardiology, Hospital Universitário Walter Cantídio, School of Medicine, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil.

ABSTRACT
Pheochromocytoma is a rare disease charactrized by excessive production of catecholamines, manifestating mainly with hypertension. We report the case of a 45-year-old woman with history of sudden onset dyspnea, headache, palpitations and sudoresis. An abdominal ultrasound was suggestive of chronic kidney disease (CKD). An abdominal computed tomography and magnetic resonance was performed and showed a mass in the topography of left adrenal. The patient underwent a surgery for the removal of the mass and became stable with normal blood pressure levels, but remained with CKD. The dalayed diagnosis of pheochromocytoma in the present case has contributed to the development of CKD.

No MeSH data available.


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(a) Adrenal tumor and (b) adrenal vein
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Figure 0002: (a) Adrenal tumor and (b) adrenal vein

Mentions: We report the case of a 45-year-old woman admitted to our hospital with a history of sudden onset dyspnea and hemoptysis. She also reported episodes of headache, palpitations and sudoresis, associated with weight loss. On physical examination, she had bilateral pulmonary crackles and blood pressure of 260/140 mmHg. Acute pulmonary edema was diagnosed and treatment with sodium nitroprusside and furosemide was suggested. Blood pressure was controlled and the patient became stable. Urinary metanephrines vanillyl mandelic acid was 25.7 mg/24 h (reference 2-14 mg/24 h), and metanephrines 519 µg/24 h (reference < 400 µg/24 h). Other laboratory test results are given in Table 1. An abdominal ultrasound was suggestive of chronic kidney disease (CKD) - right kidney measuring 9.0 × 4.0 × 5.4 cm, left kidney 9.0 × 4.2 × 4.0 cm, with no differentiation between cortex and medulla. Before hospital admission, the levels of creatinine were 1.6 and 1.8 mg/ dl. An abdominal computed tomography and magnetic resonance was performed and showed a mass shaped 4.6 × 5.0 cm in the topography of left adrenal [Figure 1]. The patient underwent surgery for the removal of the mass [Figure 2] and became stable with normal blood pressure levels, but remained with low eGFR. At hospital discharge, the eGFR was 37 ml/min. The patient is now in good clinical condition, with normal levels of blood pressure, without anti-hypertensive drugs, under conservative therapy for CKD.


Delayed diagnosis of pheochromocytoma associated with chronic kidney disease.

Fernandes GH, Silva Júnior GB, Garcia JH, Sobrinho CR, Albuquerque PL, Libório AB, Daher EF - Indian J Nephrol (2010)

(a) Adrenal tumor and (b) adrenal vein
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2966986&req=5

Figure 0002: (a) Adrenal tumor and (b) adrenal vein
Mentions: We report the case of a 45-year-old woman admitted to our hospital with a history of sudden onset dyspnea and hemoptysis. She also reported episodes of headache, palpitations and sudoresis, associated with weight loss. On physical examination, she had bilateral pulmonary crackles and blood pressure of 260/140 mmHg. Acute pulmonary edema was diagnosed and treatment with sodium nitroprusside and furosemide was suggested. Blood pressure was controlled and the patient became stable. Urinary metanephrines vanillyl mandelic acid was 25.7 mg/24 h (reference 2-14 mg/24 h), and metanephrines 519 µg/24 h (reference < 400 µg/24 h). Other laboratory test results are given in Table 1. An abdominal ultrasound was suggestive of chronic kidney disease (CKD) - right kidney measuring 9.0 × 4.0 × 5.4 cm, left kidney 9.0 × 4.2 × 4.0 cm, with no differentiation between cortex and medulla. Before hospital admission, the levels of creatinine were 1.6 and 1.8 mg/ dl. An abdominal computed tomography and magnetic resonance was performed and showed a mass shaped 4.6 × 5.0 cm in the topography of left adrenal [Figure 1]. The patient underwent surgery for the removal of the mass [Figure 2] and became stable with normal blood pressure levels, but remained with low eGFR. At hospital discharge, the eGFR was 37 ml/min. The patient is now in good clinical condition, with normal levels of blood pressure, without anti-hypertensive drugs, under conservative therapy for CKD.

Bottom Line: Pheochromocytoma is a rare disease charactrized by excessive production of catecholamines, manifestating mainly with hypertension.An abdominal ultrasound was suggestive of chronic kidney disease (CKD).An abdominal computed tomography and magnetic resonance was performed and showed a mass in the topography of left adrenal.

View Article: PubMed Central - PubMed

Affiliation: Divisions of Nephrology and Cardiology, Hospital Universitário Walter Cantídio, School of Medicine, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil.

ABSTRACT
Pheochromocytoma is a rare disease charactrized by excessive production of catecholamines, manifestating mainly with hypertension. We report the case of a 45-year-old woman with history of sudden onset dyspnea, headache, palpitations and sudoresis. An abdominal ultrasound was suggestive of chronic kidney disease (CKD). An abdominal computed tomography and magnetic resonance was performed and showed a mass in the topography of left adrenal. The patient underwent a surgery for the removal of the mass and became stable with normal blood pressure levels, but remained with CKD. The dalayed diagnosis of pheochromocytoma in the present case has contributed to the development of CKD.

No MeSH data available.


Related in: MedlinePlus