Undiagnosed phaeochromocytoma mimicking severe preeclampsia in a pregnant woman at term

Hudsmith, J; Thomas, Cynthia C.; Browne, D.A.

doi:10.1016/j.ijoa.2005.11.003

Cited by 35 publications

(25 citation statements)

References 23 publications

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“…In these conditions, hypertensive emergency, acute pulmonary edema, malignant arrhythmias, myocardial ischemia or infarction, aortic dissection, cardiac failure and hemodynamic collapse are well-recognized complications of pheochromocytoma, and the risk of death is high after such acute presentations unless appropriate therapy is instituted quickly (34). Few case reports have described such conditions, with varying outcomes for both mother and child (1,17,34,35,40,41,42,43).…”

Section: Perioperative Managementmentioning

confidence: 99%

ENDOCRINOLOGY IN PREGNANCY: Pheochromocytoma in pregnancy: case series and review of literature

Weerd

Noord

Loeve³

et al. 2017

European Journal of Endocrinology

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Pheochromocytoma in pregnancy is extremely rare. Early recognition is crucial as antepartum diagnosis can largely decrease maternal and fetal mortality rates. As symptoms of pheochromocytoma are rather similar to those of other far more common causes of hypertension during pregnancy, timely diagnosis is a challenge. In pregnant patients, similar to non-pregnant patients, increased plasma and/or 24-h urine (nor)metanephrine concentrations most reliably confirm the diagnosis of pheochromocytoma. MRI and ultrasound are the only imaging modalities that can be used safely during pregnancy to localize the tumor. During pregnancy, pretreatment consists of alpha blockade as usual. However, dosing of α-adrenergic receptor blockers during pregnancy is a challenge as hypertension must be treated while preserving adequate uteroplacental circulation. When the diagnosis is made within the first 24 weeks of pregnancy, it is generally recommended to remove the tumor in the second trimester, while resection is generally postponed till after delivery when the diagnosis is made in the third trimester and medical pretreatment is sufficient. Both during and after pregnancy, laparoscopic surgery is the preferred approach for resection of the tumor. There is no consensus in literature about the preferred route and timing of delivery. Therefore, in our opinion, decisions should be made on an individual basis by an experienced and dedicated multidisciplinary team. Over the last decades, maternal and fetal prognosis has improved considerably. Further increasing awareness of this rare diagnosis and treatment of these patients by a dedicated team in a tertiary referral hospital are critical factors for optimal maternal and fetal outcome.

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Section: Perioperative Managementmentioning

confidence: 99%

ENDOCRINOLOGY IN PREGNANCY: Pheochromocytoma in pregnancy: case series and review of literature

Weerd

Noord

Loeve³

et al. 2017

European Journal of Endocrinology

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“…When the diagnosis is missed, PIP can lead to a mortality rate of 58 % for the mother and 55 % for the fetus [18]. The clinical presentation of PIP can often be confused with preeclampsia because of the overlapping symptoms of hypertension and proteinuria (which can occur in PIP) [19,16].…”

Section: Pheochromocytoma In Pregnancymentioning

confidence: 99%

Secondary Hypertension in Pregnancy

2015

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Hypertension is a common medical complication of pregnancy. Although 75-80 % of women with preexisting essential hypertension will have uncomplicated pregnancies, the presence of secondary forms of hypertension adds considerably to both maternal and fetal morbidity and mortality. Renovascular hypertension, pheochromocytoma, and Cushing's syndrome in particular are associated with accelerating hypertension, superimposed preeclampsia, preterm delivery, and fetal loss. Primary aldosteronism is a more heterogeneous disorder; there are well-documented cases where blood pressure and hypokalemia are improved during pregnancy due to elevated levels of progesterone. However, superimposed preeclampsia, worsening hypertension, and early delivery are also reported. When possible, secondary forms of hypertension should be diagnosed and treated prior to conception in order to avoid these complications.

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“…In the pregnant patient, having pheochromocytoma, excessive uterine contractions or fetal movements, as well as normal vaginal delivery or Cesarean section may precipitate the crisis; the symptoms and signs may mimic that of severe preeclampsia. However, preeclampsia is associated with hypertension and proteinuria usually after the 20 th week of gestation, while pheochromocytoma is rarely associated with proteinuria and may cause hypertension throughout pregnancy (Mudsmith et al, 2006). ____________________________________________________________________ Anticholinergic drugs e.g.…”

Section: Pheochromocytoma Crisismentioning

confidence: 99%

Undiagnosed Pheochromocytoma Complicated with Perioperative Hemodynamic Crisis and Multiple Organ Failure

Baraka¹

2011

Pheochromocytoma - A New View of the Old Problem

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Undiagnosed phaeochromocytoma mimicking severe preeclampsia in a pregnant woman at term

Cited by 35 publications

References 23 publications

ENDOCRINOLOGY IN PREGNANCY: Pheochromocytoma in pregnancy: case series and review of literature

ENDOCRINOLOGY IN PREGNANCY: Pheochromocytoma in pregnancy: case series and review of literature

Secondary Hypertension in Pregnancy

Undiagnosed Pheochromocytoma Complicated with Perioperative Hemodynamic Crisis and Multiple Organ Failure

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