2015
DOI: 10.1111/cen.12813
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Risk of catecholaminergic crisis following glucocorticoid administration in patients with an adrenal mass: a literature review

Abstract: Although a causal relationship cannot be established from this review, it seems prudent to exclude a PPGL in patients with a large incidentaloma or when high-dose DST is considered in a patient with an incidentaloma of any size. Our literature review does not support the need for biochemical testing for PPGL prior to a low-dose (1 mg) DST. Finally, before starting therapeutic glucocorticoids, any clinical signs or symptoms of a potential PPGL should prompt reliable biochemical testing to rule out a PPGL.

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Cited by 21 publications
(21 citation statements)
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“…On the other hand, pheochromocytoma crisis after the administration of glucocorticoid has been reported and reviewed in several papers [50,51], leading to a fatal clinical course in 32% of the patients [50]. A pheochromocytoma crisis induced by the dexamethasone suppression test was also reported [52].…”
Section: Discussionmentioning
confidence: 99%
“…On the other hand, pheochromocytoma crisis after the administration of glucocorticoid has been reported and reviewed in several papers [50,51], leading to a fatal clinical course in 32% of the patients [50]. A pheochromocytoma crisis induced by the dexamethasone suppression test was also reported [52].…”
Section: Discussionmentioning
confidence: 99%
“…76 It is also crucial to be cognisant of glucocorticoid therapy in patients with catecholamine excess, and this is particularly relevant in patients with coexistent PPGL and COVID-19. 11 , 77 When a patient with COVID-19 is suspected to have an underlying PPGL, physicians need to be wary of elevations in plasma and urine metanephrines that can be observed in severe acute illness due to sympathoadrenal activation, vasopressor infusions, or other medications, even without an underlying PPGL. 78 In these situations, plasma metanephrines can elevate to concentrations similar to those observed in patients with catecholamine-producing PPGLs, precluding an unequivocal diagnosis.…”
Section: Effects Of Catecholamine Excess In Ppgl and Their Implicatiomentioning
confidence: 99%
“…Causes of PCC crisis include trauma, surgery, and anesthesia, as well as drugs such as glucagon, radiocontrast agent, tyramine, tricyclic antidepressant, and metoclopramide [3]. Cases occurring after glucocorticoid administration are very rare, with only about 20 cases reported to date [9-11]. In this case, methylprednisolone taken prior to admission was suspicious of the cause of PCC crisis.…”
Section: Discussionmentioning
confidence: 99%