Undiagnosed phaeochromocytoma masquerading as eclampsia.
The authors report the case of a previously well 34-year-old woman presenting with a hypertensive crises and a grand-mal seizure following elective caesarean section. Initial treatment of extreme hypertension, of a presumed eclamptic aetiology, with magnesium and labetalol was complicated by intermittent profound hypotensive episodes. This was accompanied by severe biventricular failure and fluctuating systemic vascular resistance. Abdominal ultrasound revealed a left suprarenal mass. A diagnosis of phaeochromocytoma was confirmed on abdominal CT and urinary assays. The patient was stabilised with α and β blockade, was successfully extubated and subsequently had the tumour surgically excised. The cardiac function returned to normal on echocardiography and she has made a complete recovery.
Department of Anaesthetics, Hillingdon Hospital, Uxbridge, UK.
Joanne
J
Petrie
Christopher
C
Lockie
Alex
A
Paolineli
Michele
M
Stevens
Mark
M
Smith
Catharine
C
Mitchell
Simon William
SW
Dubrey
D000310:Adrenal Gland Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D001794:Blood Pressure / Q000502:physiology; D003937:Diagnosis, Differential; D004461:Eclampsia / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006801:Humans; D010673:Pheochromocytoma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D011247:Pregnancy; D014057:Tomography, X-Ray Computed