title: Magnesium sulphate and (123)I-MIBG in pheochromocytoma: Two useful techniques for a complicated disease.
abstract: Pheochromocytoma is a tumour of the chromaffin tissue. It may, through catecholamine release, have deleterious effects on myocardial structure. A 48-year-old woman with a history of hypertension and type II diabetes mellitus (ASA II) was diagnosed of pheochromocytoma-induced myocarditis, which caused severe cardiogenic shock, with an ejection fraction of 20%. Extreme blood pressure swings required aggressive therapy with vasoactive drugs (norepinephrine and dopamine) and an intra-aortic balloon pump, despite which severe haemodynamic instability persisted. Finally, the use of magnesium sulphate allowed for cardiovascular stabilization and weaning off vasoactive drugs prior to surgery. (123)I-metaiodobenzylguanidine scintigraphy helps not only to functionally confirm tumour tissue, but also to assess severity and prognosis of cardiac failure. Prognosis of pheochromocytoma-induced heart failure can be very poor. The use of these two well-known and relatively simple 'tools' for treatment and prognosis is a helpful option to keep in mind.
authors.affiliation: Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Hospital Clínic Barcelona, Spain. Electronic address: marina_vendrell@hotmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Vendrell
authors.affiliation: Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Hospital Clínic Barcelona, Spain.
authors.forename: N
authors.initials: N
authors.lastname: Martín
authors.affiliation: Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Hospital Clínic Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Tejedor
authors.affiliation: Servicio de Cardiología, Hospital Clínic Barcelona, Spain.
authors.forename: J T
authors.initials: JT
authors.lastname: Ortiz
authors.affiliation: Servicio de Medicina Nuclear, Hospital Clínic Barcelona, Spain.
authors.forename: À
authors.initials: À
authors.lastname: Muxí
authors.affiliation: Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Hospital Clínic Barcelona, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Taurà
mesh_terms: D019797:3-Iodobenzylguanidine; D000310:Adrenal Gland Neoplasms; D003924:Diabetes Mellitus, Type 2; D005260:Female; D006801:Humans; D008278:Magnesium Sulfate; D008875:Middle Aged; D010673:Pheochromocytoma
chemical_list: D019797:3-Iodobenzylguanidine; D008278:Magnesium Sulfate
keywords: Feocromocitoma; Gammagrafía; Magnesium sulphate; Pheochromocytoma; Scintigraphy; Sulfato de magnesio