Unmasking of paraganglioma after initiation of peritoneal dialysis.

Nephrology (Carlton)

Renal Division, Department of Medicine, Khoo Teck Puat Hospital, Yishun, Singapore.

Published: October 2019

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Source
http://dx.doi.org/10.1111/nep.13534DOI Listing

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Article Synopsis
  • - Catecholamine-secreting tumors (CSTs) are rare but can pose serious risks for both mother and baby during pregnancy, often complicating diagnosis due to similarities with conditions like preeclampsia.
  • - A case study of a 24-year-old pregnant woman revealed that timely management of hypertension and surgical intervention were crucial; she was diagnosed with a CST at 27 weeks, managed with medication, and had an elective cesarean at 32 weeks, delivering a healthy baby.
  • - Successful outcomes depend on early diagnosis, tailored medical and surgical approaches, and teamwork among various healthcare specialists, emphasizing the need for heightened awareness of CSTs in hypertensive pregnant patients.
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Background: The mechanisms by which pregnancy may unmask pheochromocytomas and paragangliomas are not totally understood. We hypothesized that gestational hormones may participate in the pathophysiology of catecholamine excess during pregnancy. We report a case of silent pheochromocytoma revealed in a pregnant woman by life-threatening adrenergic myocarditis.

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Pheochromocytoma is a tumor arising from chromaffin cells of the medulla of adrenal gland and secretes excessive amounts of catecholamines: epinephrine and norepinephrine. It can also arise from sympathetic ganglia when it is referred to as catecholamine-secreting paragangliomas or extra-adrenal pheochromocytoma. Pheochromocytoma has been referred to as "the masquerader" for its numerous atypical presentations, which makes its diagnosis medically challenging.

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