Shock after phenothiazine administration in a pregnant patient with a pheochromocytoma. A case report and literature review.
A pregnant patient with undiagnosed bilateral pheochromocytoma developed shock and pulmonary edema subsequent to the administration of a phenothiazine. The patient had developed a paradoxic hypertensive response to hydralazine. A high index of suspicion is required for diagnosing a pheochromocytoma that mimics toxemia of pregnancy. There is an urgent need for prompt plasma expansion for the pregnant patient in shock, even when pulmonary edema is present.
D000310:Adrenal Gland Neoplasms / Q000175:diagnosis*; D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006830:Hydralazine / Q000009:adverse effects; D006973:Hypertension / Q000188:drug therapy; D010640:Phenothiazines / Q000009:adverse effects*; D010673:Pheochromocytoma / Q000175:diagnosis*; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis*; D011398:Promethazine / Q000009:adverse effects; D011654:Pulmonary Edema / Q000139:chemically induced*; D012769:Shock / Q000139:chemically induced*
D010640:Phenothiazines; D006830:Hydralazine; D011398:Promethazine