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Cardiac failure due to epinephrine-secreting pheochromocytoma: clinical, laboratory and pathological findings in a sudden death.

Abstract：

:A rare case of cardiac failure due to hypertensive crisis in pheochromocytoma in a 25-year-old young man is presented. In the Emergency Department the patient complained of persisting headache and vomiting; he was distressed but fully alert, his heart rate was 110 b/min and blood pressure 180/80 mmHg. Few hours after admission, the clinical course suddenly got worse with signs and symptoms of fatal cardiac shock (dyspnoea, cyanosis, pulmonary oedema, hypocontractility of left ventricle). Autopsy revealed a large tumour of the left adrenal gland. Histological examination confirmed macroscopic suspicion of pheochromocytoma. Catecholamine serum levels were analysed by high pressure liquid chromatography (HPLC) with electrochemical detection. The urine contained 35 microg/24 h norepinephrine and 184 microg/24 h epinephrine (normal range < or = 64 and < or = 36 microg/24 h respectively). These laboratory findings impressively demonstrate that the tumour was active, secreting high levels of epinephrine. Cardiac failure due to an acute catecholamine-related hypertensive crisis was established as the cause of death.

journal_name

Forensic Sci Int

journal_title

Forensic science international

authors

D'Errico S,Pomara C,Riezzo I,Neri M,Turillazzi E,Fineschi V

doi

10.1016/j.forsciint.2009.01.021

subject

Has Abstract

pub_date

2009-05-30 00:00:00

pages

e13-7

issue

1-3

eissn

0379-0738

issn

1872-6283

pii

S0379-0738(09)00050-4

journal_volume

187

pub_type

杂志文章

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