Diagnosis and treatment of pheochromocytoma in pregnancy: a case report
Online published: 2016-04-18
患者,女性,27岁,平素月经规律,末次月经2014年1月6日,预产期2014年10月13日。停经8周出现恶心、呕吐等早孕反应,较剧烈,持续至孕4个月,于当地医院查尿酮体间断阳性,予补液等治疗后好转。停经25周查空腹血糖5.57 mmol/L,诊断为妊娠期糖尿病,经运动、饮食控制后血糖基本达标。1个月前无明显诱因自觉胸闷,出现间断发热、出汗,伴恶心、呕吐、心悸、头晕,每日发作约10余次,渐频繁,就诊外院查血压145/100 mmHg(1 mmHg=0.133 kPa), 后复查血压正常。2周前因起身时晕厥就诊外院,予补液治疗,1 d前无明显诱因出现胸闷、喘憋,平卧时加重,血压175/100 mmHg,尿蛋白(+++),考虑重度子痫前期,给予解痉、降压、补液治疗。腹部超声提示腹腔占位,性质待查,以“重度子痫前期,腹部包块性质待查”转诊入北京大学人民医院。
杨莹超 , 刘国莉 , 周敬伟 , 胡浩 , 沈丹华 . 妊娠合并嗜铬细胞瘤1例[J]. 北京大学学报(医学版), 2016 , 48(2) : 370 -372 . DOI: 10.3969/j.issn.1671-167X.2016.02.036
Pheochromocytoma is rare in pregn’ancy. Clinical features of a case of pheochromocytoma during pregnancy in the Peking University People’s Hospital was investigated and the literature reviewed to discuss the diagnosis and treatment of this disease. The patient manifested with hypertension and proteinuria, who was easily misdiagnosed with gestational hypertension disease. When she was transferred to our hospital, the symptoms such as, paroxysmal palpitation, dizziness, vomiting were noticed, and the possibility of pheochromocytoma was considered due to the accompanying abdominal mass. An emergent cesarean section was performed successfully due to preterm labor during the treatment of the disease. After the delivery the drug preparation continued. And the laparoscopic resection of pheochromocytoma proceeded when the blood pressure was steady. The patient recovered fully after the surgery. The final diagnosis of pheochromocytoma was confirmed with the pathology. Its diagnosis and treatment experiences could improve our understanding and treatment of secondary hypertension due to pheochromocytoma in pregnancy.
Key words: Pheochromocytoma; Hypertension; Pregnancy
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