糖皮质激素诱发嗜铬细胞瘤致儿茶酚胺心肌病1例

Catecholamine induced cardiomyopathy in pheochromocytoma following glucocorticoid administration:a case report

1病例资料 患者,女,37岁,因＂突发心悸、胸闷伴头痛10h＂入院。患者入院前10h于睡眠中突发心悸、胸闷,伴头痛,位于顶枕部,感四肢乏力,无胸痛、腹痛及腰痛,无发热、晕厥及呕吐,症状持续不能缓解。入院前10d有上呼吸道感染史。入院前5d进食螃蟹后出现腹痛、腹泻、皮疹,外院诊断＂食物过敏＂,予＂泼尼松＂40mg治疗。

Pheochromocytoma commonly presents with symptoms and signs of catecholamine excess,such as hypertension,tachycardia and headache.Cardiovascular manifestations include catecholamine-induced cardiomyopathy,which may present as severe left ventricular dysfunction and congestive heart failure.Glucocorticoids have been reported to carry an increased risk of catecholaminergic crisis in patients with pheochromocytoma.We report a case of a 37-year-old female,who presented with features of pheochromocytoma induced cardiomyopathy with severe left ventricular dysfunction following glucocorticoid administration.We highlight the dramatic symptomatic improvement and reversal of cardiomyopathy.