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Fatal form of phaeochromocytoma presenting as acute pyelonephritis

Published online by Cambridge University Press:  16 August 2006

C. Winter
Affiliation:
Department of Anaesthesiology, Hôpital Civil, Hôpitaux Universitaires, 67091 Strasbourg Cćdex, France
C. Schmidt-Mutter
Affiliation:
Department of Anaesthesiology, Hôpital Civil, Hôpitaux Universitaires, 67091 Strasbourg Cćdex, France
R. Cuny
Affiliation:
Department of Anaesthesiology, Hôpital Civil, Hôpitaux Universitaires, 67091 Strasbourg Cćdex, France
S. Soulas
Affiliation:
Department of Anaesthesiology, Hôpital Civil, Hôpitaux Universitaires, 67091 Strasbourg Cćdex, France
J.-P Dupeyron
Affiliation:
Department of Anaesthesiology, Hôpital Civil, Hôpitaux Universitaires, 67091 Strasbourg Cćdex, France
A. Steib
Affiliation:
Department of Anaesthesiology, Hôpital Civil, Hôpitaux Universitaires, 67091 Strasbourg Cćdex, France
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Abstract

We report the case of a young man who presented with a clinical picture of acute pyelonephritis. Within 3 h of admission, the patient developed acute respiratory distress associated with tachycardia and shock, and he was transferred to the intensive care unit. Mechanical ventilation of the lungs and symptomatic treatment were started immediately. Abdominal ultrasound revealed the presence of an adrenal tumour with central necrosis indicating a probable phaeochromocytoma. There was no sign of pyelonephritis. Ventricular fibrillation followed by asystole occurred soon after admission. The suddenness of the patient’s death did not allow time for further investigation and therapy. The severity of the clinical signs was probably related to a massive release of catecholamines because of necrosis of the tumour, which may have been worsened by the diagnostic procedures performed to investigate the clinical symptoms and signs of acute pyelonephritis.

Type
Clinical Letter
Copyright
2001 European Society of Anaesthesiology

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