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Endocrine Abstracts (2018) 59 CMW2.2 | DOI: 10.1530/endoabs.59.CMW2.2

Cambridge University NHS Foundation Trust, Cambridge, UK.


A phaeochromocytoma is a catecholamine secreting tumour arising from the adrenal medulla and a paraganglioma refers to its extra adrenal counterpart, which can develop from sympathetic or parasympathetic tissue anywhere from the skull base to the pelvis. Presenting symptoms of these rare tumours are most commonly related to catecholamine excess, and include headache, palpitations, paroxysmal hypertension, anxiety, abdominal pain and excessive sweating. A phaeochromocytoma crisis is a life-threatening endocrine emergency defined as catecholamine-induced hemodynamic instability including; labile blood pressure, tachyarrhythmias and the risk of subsequent cardiovascular collapse. Although catecholamine crises are rare with an estimated incidence of 11% (1), the associated pooled mortality rates are significant at approximately 15% (2). Severe complications of a catecholamine crisis include cardiomyopathy, myocardial infarction, pulmonary oedema, cerebrovascular accident and ischaemic ileus (1). A phaeochromocytoma is regarded as the ‘great mimicker’ and therefore early consideration of this diagnosis should be given to those patients presenting with unexplained cardiovascular or hemodynamic compromise. Early cautious treatment with alpha-blockade remains the first line treatment option for a catecholamine crisis. However, invasive pressure monitoring and cross-specialty input from cardiology, endocrinology, intensive care and surgical colleagues is often crucial in achieving the best patient outcomes. This management session will involve a cased-based and interactive discussion focusing on: (i) potential presenting symptoms of a phaeochromocytoma crisis; (ii) risk factors and precipitants of a crisis; (iii) complications of a crisis; and, (iv) suitable management strategies.

References

1. Riester A, Weismann D, Quinkler M, Lichtenauer UD, Sommerey S, Halbritter R, et al. Life-threatening events in patients with pheochromocytoma. Eur J Endocrinol [Internet]. 2015 Dec;173(6):757–64. Available from: http://www.ncbi.nlm.nih.gov/pubmed/2634613.

2. Whitelaw BC, Prague JK, Mustafa OG, Schulte K-M, Hopkins PA, Gilbert JA, et al. Phaeochromocytoma [corrected] crisis. Clin Endocrinol (Oxf) [Internet]. 2014 Jan;80(1):13–22. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24102156.

Volume 59

Society for Endocrinology BES 2018

Glasgow, UK
19 Nov 2018 - 21 Nov 2018

Society for Endocrinology 

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