Cardiac failure due to epinephrine-secreting pheochromocytoma: Clinical, laboratory and pathological findings in a sudden death

被引：13

作者：

D'Errico, Stefano ^{[1
]}

Pomara, Cristoforo ^{[1
]}

Riezzo, Irene ^{[1
]}

Neri, Margherita ^{[1
]}

Turillazzi, Emanuela ^{[1
]}

Fineschi, Vittorio ^{[1
]}

机构：

[1] Univ Foggia, Dept Forens Pathol, Osped Colonnello DAvanzo, I-71100 Foggia, Italy

来源：

FORENSIC SCIENCE INTERNATIONAL | 2009年 / 187卷 / 1-3期

关键词：

Pheochromocytoma; Cardiac failure; Sudden death; Epinephrine dosage; Heart morphology;

D O I：

10.1016/j.forsciint.2009.01.021

中图分类号：

DF [法律]; D9 [法律]; R [医药、卫生];

学科分类号：

0301 ; 10 ;

摘要：

A rare case of cardiac failure due to hypertensive crisis in pheochromocytoma in a 25-year-old young man is presented. In the Emergency Department the patient complained of persisting headache and vomiting; he was distressed but fully alert, his heart rate was 110 b/min and blood pressure 180/80 mmHg. Few hours after admission, the clinical course suddenly got worse with signs and symptoms of fatal cardiac shock (dyspnoea, cyanosis, pulmonary oedema, hypocontractility of left ventricle). Autopsy revealed a large tumour of the left adrenal gland. Histological examination confirmed macroscopic suspicion of pheochromocytoma. Catecholamine serum levels were analysed by high pressure liquid chromatography (HPLC) with electrochemical detection. The urine contained 35 mu g/24 h norepinephrine and 184 mu g/24 h epinephrine (normal range <= 64 and <= 36 mu g/24 h respectively). These laboratory findings impressively demonstrate that the tumour was active, secreting high levels of epinephrine. Cardiac failure due to an acute catecholamine-related hypertensive crisis was established as the cause of death. (C) 2009 Elsevier Ireland Ltd. All rights reserved.

引用

页码：E13 / E17

页数：5

共 11 条

[1] Comparison of diagnostic accuracy of urinary free metanephrines, vanillyl mandelic acid, and catecholamines and plasma catecholamines for diagnosis of pheochromocytoma [J].