title: A missed diagnosis or a masquerading disease: back to the basics.
abstract: A 23-year-old gravid Ugandan female at 26 weeks was admitted to the maternity ward with sweats, abdominal pain, feeling of apprehension and palpitations. A diagnosis of pre-eclampsia was made and treatment with magnesium sulphate initiated. She was later transferred to intensive care unit for monitoring and control of blood pressure. Due to her labile blood pressures despite intravenous hydralazine and metoprolol, the pregnancy was terminated. However, she continued to have labile blood pressures. Better control of blood pressure was achieved on oral prazocin and nifedipine. The patient was then transferred to floor and discharged home a few days later. An abdominal computed-tomography scan showed a solid lobulated right paravertebral mass superio-medial to the right kidney. An open adrenelectomy was performed and antihypertensives discontinued. Histopathology revealed a benign pheochromocytoma. The mother had good post-operative outcome; however the premature baby died 2 days later in the special care unit.
authors.affiliation: Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, P. O. Box: 7072, Kampala, Uganda.
authors.forename: Rejani
authors.initials: R
authors.lastname: Lalitha
authors.forename: Christopher Kenneth
authors.initials: CK
authors.lastname: Opio
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D010673:Pheochromocytoma / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D011225:Pre-Eclampsia / Q000175:diagnosis; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis / Q000209:etiology; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D011256:Pregnancy Outcome; D014057:Tomography, X-Ray Computed; D014454:Uganda; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents
keywords: Pre-eclampsia; blood pressures; magnesium sulphate; pheochromocytoma