심인성 폐부종과 폐포성 출혈을 보인 갈색세포종 1예
A Case of Pheochromocytoma Accompanied with Alveolar Hemorrhage and Cardiogenic Pulmonary Edema
김유일 (전남대학교)
임성철 (전남대학교)
김영철 (한중대학교)
반희정 (전남의대)
김수옥 (미래로21병원)
손준광 (서남의대)
주진영 (전남의대)
권용수 (전남대학교)
오인재 (전남의대)
김규식 (전남대학교)
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- 조회수
초록
저자들은 대량 객혈로 내원한 환자에서 폐 출혈과 함께 반복적인 심인성 폐부종, 카테콜라민 유도성 심부전이 합병된 드문 형태의 갈색세포종을 경험하여 이러한 임상 증상시 폐나 심장 질환 외에 갈색세포종에 대한 고려가 필요할 것으로 생각되어 문헌고찰과 함께 보고하는 바이다.
- keywords
- Pheochromocytoma, Alveolar hemorrhage, Cardiogenic pulmonary edema
Abstract
Pheochromocytoma is derived from the chromaffin tissue. The typical finding of pheochromocytoma is paroxysmal hypertension accompanied with various signs and symptoms that are due to the excess of catecholamines or other bioactive substances. Yet the diagnosis is sometimes difficult to make because its clinical presentation is quite variable. Especially, hemoptysis is a very rare symptom, so the diagnosis is often missed or delayed. Without making the correct diagnosis and then subsequently administering treatment, the condition may be fatal. We herein report on a 68 year-old woman who was admitted because of abdominal pain and hemoptysis. The initial radiologic findings suggested pulmonary edema with alveolar hemorrhage. The urine catecholamine levels were elevated and she developed catecholamine-induced cardiomyopathy. We performed bronchial arterial embolization and we administered alpha blocker medication for controlling the hemoptysis and hypertension. After the temporary symptomatic improvement, her clinical course was aggravated by pneumonia and pulmonary edema. In spite of performing definitive surgery for pheochromocytoma, she died of postoperative hemodynamic instability.
- keywords
- Pheochromocytoma, Alveolar hemorrhage, Cardiogenic pulmonary edema
참고문헌
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