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Malignant Pheochromocytoma Associated with Jaccoud's – Type Arthropathy, Raynaud's Phenomenon, Positive Antinuclear Antibody and Rheumatoid Factor

惡性嗜鉻細胞瘤併發Jaccoud's型關節炎,電諾氏現象,陽性抗核抗體和類風濕因子

摘要


嗜鉻細胞瘤是一種分泌Catecholamine的腫瘤,臨床表現以交感神經亢進的症狀為主,如陣發性高血壓、頭痛、心悸或易出汗。咾鉻細胞瘤呈現風濕免疫四面的症狀則不多見。 一位47歲女性病人,過去身體狀況良好,主訴最近一年來,手部關節逐漸變形但卻不疼痛,且併有雷諾氏現象。血清檢查發現抗核抗體及風濕因子皆呈陽性。住院後發現有高血壓提醒我們嗜鉻細胞瘤的可能。經一系列檢查及開刀後證實為惡性咾鉻細胞瘤。術後長期門診追蹤發現手部關節停止變形,雷諾氏現象消失,且抗核抗體及風濕因子皆轉成陰性。 嗜鉻細胞瘤有雷諾氏現象的症狀,偶有病例報告。但以Jaccoud’s型關節炎、抗核抗體及風濕因子陽性為表現之嗜鉻細胞瘤,則迄今未曾有文獻報告。

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並列摘要


We describe a patient with malignant pheochromocytoma who developed Jaccoud’s-type arthropathy and Raynaud’s phenomenon as initial manifestations of malignant pheochromocytoma. Serologic findings included postitive antinuclear antibody (ANA) and rheumatoid factor (RF) was also found in this patient. To our knowledge, this is the first time Jaccoud’s-type arthropathy with positive ANA and RF has been reported as rheumatic manifestations of pheochromocytoma.

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