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Microangiopathic Hemolytic Anemia and Fulminant Renal Failure: A Rare Manifestation of Pheochromocytoma

Pheochromocytoma is a rare adrenal tumor that is classically associated with the triad of paroxysmal tachycardia, diaphoresis, and headaches. However, it can have myriad manifestations. We present a case of a 31-year-old male who presented with abdominal pain, hypertensive emergency, and renal failu...

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Autores principales: Sharma, Nishant, Ravi, Divya, Khan, Mehvish, Sravanthi, Metlapalli Venkata, Aloysius, Mark M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6942720/
https://www.ncbi.nlm.nih.gov/pubmed/31929915
http://dx.doi.org/10.1155/2019/2397638
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author Sharma, Nishant
Ravi, Divya
Khan, Mehvish
Sravanthi, Metlapalli Venkata
Aloysius, Mark M.
author_facet Sharma, Nishant
Ravi, Divya
Khan, Mehvish
Sravanthi, Metlapalli Venkata
Aloysius, Mark M.
author_sort Sharma, Nishant
collection PubMed
description Pheochromocytoma is a rare adrenal tumor that is classically associated with the triad of paroxysmal tachycardia, diaphoresis, and headaches. However, it can have myriad manifestations. We present a case of a 31-year-old male who presented with abdominal pain, hypertensive emergency, and renal failure. Abdominal imaging demonstrated a left adrenal mass. Plasma metanephrines (153 pg/ml, n < 57) and normetanephrines (1197 pg/ml, n < 148) were noted to be elevated, leading to the diagnosis of pheochromocytoma. Intravenous antihypertensives were utilized to control his blood pressure. Hemodialysis was initiated given the degree of renal dysfunction. The patient subsequently developed hemolytic anemia, requiring the transfusion of multiple units of packed red cells. He developed acute respiratory failure leading to intubation, but was thereafter liberated from the ventilator following clinical stabilization. Uncontrolled hypertension precipitated by pheochromocytoma can cause microangiopathic hemolytic anemia and renal insufficiency. This case is notable not only for the occurrence of this rare presentation, but also for the severity of manifestations in a young male with no known significant comorbidities.
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spelling pubmed-69427202020-01-12 Microangiopathic Hemolytic Anemia and Fulminant Renal Failure: A Rare Manifestation of Pheochromocytoma Sharma, Nishant Ravi, Divya Khan, Mehvish Sravanthi, Metlapalli Venkata Aloysius, Mark M. Case Rep Endocrinol Case Report Pheochromocytoma is a rare adrenal tumor that is classically associated with the triad of paroxysmal tachycardia, diaphoresis, and headaches. However, it can have myriad manifestations. We present a case of a 31-year-old male who presented with abdominal pain, hypertensive emergency, and renal failure. Abdominal imaging demonstrated a left adrenal mass. Plasma metanephrines (153 pg/ml, n < 57) and normetanephrines (1197 pg/ml, n < 148) were noted to be elevated, leading to the diagnosis of pheochromocytoma. Intravenous antihypertensives were utilized to control his blood pressure. Hemodialysis was initiated given the degree of renal dysfunction. The patient subsequently developed hemolytic anemia, requiring the transfusion of multiple units of packed red cells. He developed acute respiratory failure leading to intubation, but was thereafter liberated from the ventilator following clinical stabilization. Uncontrolled hypertension precipitated by pheochromocytoma can cause microangiopathic hemolytic anemia and renal insufficiency. This case is notable not only for the occurrence of this rare presentation, but also for the severity of manifestations in a young male with no known significant comorbidities. Hindawi 2019-12-14 /pmc/articles/PMC6942720/ /pubmed/31929915 http://dx.doi.org/10.1155/2019/2397638 Text en Copyright © 2019 Nishant Sharma et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Sharma, Nishant
Ravi, Divya
Khan, Mehvish
Sravanthi, Metlapalli Venkata
Aloysius, Mark M.
Microangiopathic Hemolytic Anemia and Fulminant Renal Failure: A Rare Manifestation of Pheochromocytoma
title Microangiopathic Hemolytic Anemia and Fulminant Renal Failure: A Rare Manifestation of Pheochromocytoma
title_full Microangiopathic Hemolytic Anemia and Fulminant Renal Failure: A Rare Manifestation of Pheochromocytoma
title_fullStr Microangiopathic Hemolytic Anemia and Fulminant Renal Failure: A Rare Manifestation of Pheochromocytoma
title_full_unstemmed Microangiopathic Hemolytic Anemia and Fulminant Renal Failure: A Rare Manifestation of Pheochromocytoma
title_short Microangiopathic Hemolytic Anemia and Fulminant Renal Failure: A Rare Manifestation of Pheochromocytoma
title_sort microangiopathic hemolytic anemia and fulminant renal failure: a rare manifestation of pheochromocytoma
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6942720/
https://www.ncbi.nlm.nih.gov/pubmed/31929915
http://dx.doi.org/10.1155/2019/2397638
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