Rare presentation of collapse and cardiomyopathy in phaeochromocytoma
A phaeochromocytoma is a rare neuroendocrine tumour derived from the chromaffin cells of the adrenal medulla. Tumours can produce excessive amounts of catecholamines. The presenting symptoms can vary but often include the classic triad of episodic headaches, sweating and palpitations. Due to catecho...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Bioscientifica
2021-05-01
|
| Series: | Endocrinology, Diabetes & Metabolism Case Reports |
| Online Access: | https://edm.bioscientifica.com/view/journals/edm/2021/1/EDM20-0198.xml |
| _version_ | 1818613168048439296 |
|---|---|
| author | Rajiv Singh Cynthia Mohandas |
| author_facet | Rajiv Singh Cynthia Mohandas |
| author_sort | Rajiv Singh |
| collection | DOAJ |
| description | A phaeochromocytoma is a rare neuroendocrine tumour derived from the chromaffin cells of the adrenal medulla. Tumours can produce excessive amounts of catecholamines. The presenting symptoms can vary but often include the classic triad of episodic headaches, sweating and palpitations. Due to catecholamine excess, patients can develop cardiomyopathy. Bradycardia and collapse could be the result of sinus node dysfunction or transient dysregulation of the autonomic nervous system. Patients with co-existing diabetes can have improvement or resolution of their diabetes after successful adrenalectomy. We report a case of an 87-year-old lady who initially presented with sweating, palpitations and collapse, resulting in a permanent pacemaker insertion. She was later found to have a large adrenal incidentaloma with subsequent markedly elevated plasma metanephrine levels. She later presented with chest pain and in acute pulmonary oedema with normal coronary arteries visualised on coronary angiogram. After surgical excision of her phaeochromocytoma, her diabetes resolved with her HbA1c improving from 68 to 46 mmol/mol, with no further requirement for diabetic medications. Her pulmonary oedema improved with no ongoing need for diuretic therapy. This case highlights that phaeochromocytomas can affect multiple systems and there should be a very high index of suspicion in patients presenting with sweating, palpitations, hypertension and a history of diabetes and even in those with collapse. |
| first_indexed | 2024-12-16T15:57:49Z |
| format | Article |
| id | doaj.art-13429fbc462e4a1fa929d3ef6741984e |
| institution | Directory Open Access Journal |
| issn | 2052-0573 2052-0573 |
| language | English |
| last_indexed | 2024-12-16T15:57:49Z |
| publishDate | 2021-05-01 |
| publisher | Bioscientifica |
| record_format | Article |
| series | Endocrinology, Diabetes & Metabolism Case Reports |
| spelling | doaj.art-13429fbc462e4a1fa929d3ef6741984e2022-12-21T22:25:32ZengBioscientificaEndocrinology, Diabetes & Metabolism Case Reports2052-05732052-05732021-05-01111510.1530/EDM-20-0198Rare presentation of collapse and cardiomyopathy in phaeochromocytomaRajiv Singh0Cynthia Mohandas1Department of Internal Medicine, Darent Valley Hospital, Dartford, UKDepartment of Diabetes and Endocrinology, Darent Valley Hospital, Dartford, UKA phaeochromocytoma is a rare neuroendocrine tumour derived from the chromaffin cells of the adrenal medulla. Tumours can produce excessive amounts of catecholamines. The presenting symptoms can vary but often include the classic triad of episodic headaches, sweating and palpitations. Due to catecholamine excess, patients can develop cardiomyopathy. Bradycardia and collapse could be the result of sinus node dysfunction or transient dysregulation of the autonomic nervous system. Patients with co-existing diabetes can have improvement or resolution of their diabetes after successful adrenalectomy. We report a case of an 87-year-old lady who initially presented with sweating, palpitations and collapse, resulting in a permanent pacemaker insertion. She was later found to have a large adrenal incidentaloma with subsequent markedly elevated plasma metanephrine levels. She later presented with chest pain and in acute pulmonary oedema with normal coronary arteries visualised on coronary angiogram. After surgical excision of her phaeochromocytoma, her diabetes resolved with her HbA1c improving from 68 to 46 mmol/mol, with no further requirement for diabetic medications. Her pulmonary oedema improved with no ongoing need for diuretic therapy. This case highlights that phaeochromocytomas can affect multiple systems and there should be a very high index of suspicion in patients presenting with sweating, palpitations, hypertension and a history of diabetes and even in those with collapse.https://edm.bioscientifica.com/view/journals/edm/2021/1/EDM20-0198.xml |
| spellingShingle | Rajiv Singh Cynthia Mohandas Rare presentation of collapse and cardiomyopathy in phaeochromocytoma Endocrinology, Diabetes & Metabolism Case Reports |
| title | Rare presentation of collapse and cardiomyopathy in phaeochromocytoma |
| title_full | Rare presentation of collapse and cardiomyopathy in phaeochromocytoma |
| title_fullStr | Rare presentation of collapse and cardiomyopathy in phaeochromocytoma |
| title_full_unstemmed | Rare presentation of collapse and cardiomyopathy in phaeochromocytoma |
| title_short | Rare presentation of collapse and cardiomyopathy in phaeochromocytoma |
| title_sort | rare presentation of collapse and cardiomyopathy in phaeochromocytoma |
| url | https://edm.bioscientifica.com/view/journals/edm/2021/1/EDM20-0198.xml |
| work_keys_str_mv | AT rajivsingh rarepresentationofcollapseandcardiomyopathyinphaeochromocytoma AT cynthiamohandas rarepresentationofcollapseandcardiomyopathyinphaeochromocytoma |