嗜鉻細胞瘤引起之重度高血壓：急診病例報告及文獻回顧

Severe Hypertension Induced by Pheochromocytoma: A Case Report and Review of Literature

吳宗穎(Chung-Yin Wu) ； 陳盟榮(Eric Chen) ； 周劍文(Gien-Wen Chio)

《中華民國急救加護醫學會雜誌》 10卷3期 (1999/09) Pp. 125-130

https://doi.org/10.30018/JECCM.199909.0006

摘要

嗜鉻細胞瘤為腎上腺髓質所產生的腫瘤，此腫瘤會分泌兒茶酚氨造成血壓的不穩定上升。臨床上如果將此種高血壓之病患當成原發性高血壓來處理，則無法將病患之血壓控制穩定。本文介紹一位32歲之男性病患，因主訴突發性高血壓及頭痛來急診就醫，經檢查後除高血壓外並無其他發現，在給予口服藥後回家。但隔天又因同樣症狀合併重度高血壓及蒼白、冒汗來求診，經高度懷疑為一嗜鉻細胞瘤，並經尿液、超音波及電腦斷層檢查證實，再轉由泌尿科進行手術。因嗜鉻細胞瘤所引起之高血壓與一般原發性高血壓之臨床表現與治療均不相同，如果逕行使用一般之降壓藥物或是在數種降壓藥之閒做調整更換，而未作進一步之檢查徹底根治，可能會使病患之病情惡化。此例乃是由急診室證實之病例，特別提出讓各位醫護人員作參考。

關鍵字

嗜鉻細胞瘤 ； 兒茶酚氨

並列摘要

Pheochromocytomas produce and secrete catecholamines, so it can cause hypertension. Although it is an uncommon cause of secondary hypertension, it represents a curable form of hypertension. They are usually derived from the adrenal medulla but some of them may develop from chromaffin cells in sympathetic ganglia. With proper treatment, patients with pheochromocytoma have excellent recovery. The symptom in combination with laboratory test is important for diagnosis of pheochromocytoma. We report a case of 32-year-old male with severe headache, hypertension, hyperhidrosis, and palpitation. The patient has no past history or family history of hypertension. Phsical examination showed no other difference from regulat hypertension patient. However, hypertension persists after the anti-HIT medication. Laboratory tests including 24 hours urine vanillymandelic acid and metanephrines tests, and image study with CT-Scan verify that the patient has adrenal pheochromocytoma. This article emphasizes the importance of accurate diagnosis of pheochromocytoma. If the patient was misdiagnosed or improperly treated as one with primary hypertension, pheochromocytoma wound cause serious complications.

並列關鍵字

pheochromocytoma ； catecholamine