title: Pheochromocytoma with markedly abnormal liver function tests and severe leukocytosis.
abstract: Pheochromocytoma is a rare neuroendocrine tumor arising from the medulla of the adrenal glands, which causes an overproduction of catecholamines. The common symptoms are headache, palpitations, and sweating; however, various other clinical manifestations might also be present. Accurate diagnosis of pheochromocytoma is important because surgical treatment is usually successful, and associated clinical problems are reversible if treated early. A 49-year-old man with a history of uncontrolled hypertension and diabetes mellitus presented with chest pain, fever, and sweating. His liver function tests and white blood cell counts were markedly increased and his echocardiography results suggested stress-induced cardiomyopathy. His abdominal computed tomography showed a 5×5-cm-sized tumor in the left adrenal gland, and laboratory tests confirmed catecholamine overproduction. After surgical resection of the left adrenal gland, his liver function tests and white blood cell counts normalized, and echocardiography showed normal cardiac function. Moreover, his previous antihypertensive regimen was deescalated, and his previously uncontrolled blood glucose levels normalized without medication.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
authors.forename: Chai Ryoung
authors.initials: CR
authors.lastname: Eun
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
authors.forename: Jae Hee
authors.initials: JH
authors.lastname: Ahn
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
authors.forename: Ji A
authors.initials: JA
authors.lastname: Seo
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
authors.forename: Nan Hee
authors.initials: NH
authors.lastname: Kim
keywords: Leukocytes; Liver function tests; Pheochromocytoma
references.citation: Clin Endocrinol (Oxf). 1983 Jan;18(1):37-41
references.pmid: 6303636
references.citation: JAMA. 2002 Mar 20;287(11):1427-34
references.pmid: 11903030
references.citation: Ir J Med Sci. 1995 Apr-Jun;164(2):146-50
references.pmid: 7607842
references.citation: J Clin Endocrinol Metab. 2007 Dec;92(12):4602-8
references.pmid: 17635948
references.citation: Nat Clin Pract Cardiovasc Med. 2008 Jan;5(1):22-9
references.pmid: 18094670
references.citation: Diabetes Res Clin Pract. 1994 Oct;24 Suppl:S129-33
references.pmid: 7859594
references.citation: Urology. 2006 Apr;67(4):846.e19-20
references.pmid: 16600345
references.citation: J Clin Endocrinol Metab. 2003 Aug;88(8):3632-6
references.pmid: 12915647
references.citation: J Clin Endocrinol Metab. 2003 Oct;88(10):4533-9
references.pmid: 14557417
references.citation: Ann Intern Med. 1961 Jul;55:127-34
references.pmid: 13701725
references.citation: Endocr J. 2005 Apr;52(2):193-8
references.pmid: 15863947
references.citation: Rev Endocr Metab Disord. 2003 May;4(2):121-8
references.pmid: 12766539
references.citation: Brain Behav Immun. 1996 Jun;10(2):77-91
references.pmid: 8811932
references.citation: J Clin Invest. 1980 Mar;65(3):682-9
references.pmid: 6243675
references.citation: Lancet. 2005 Aug 20-26;366(9486):665-75
references.pmid: 16112304
references.citation: Arch Intern Med. 2000 Oct 23;160(19):2957-63
references.pmid: 11041903
references.citation: Am J Physiol. 1988 Mar;254(3 Pt 2):H452-8
references.pmid: 3348424
references.citation: Biochim Biophys Acta. 2000 Dec 15;1535(1):36-44
references.pmid: 11113629