Case of reversible diabetes mellitus in the setting of benign pheochromocytoma

Cha, Jeeyeon; Khurram, Muhammad; Gellert, Lan L.; Epstein, Paul N.; Baregamian, Naira; Hendrickson, Chase D.

doi:10.1016/j.jecr.2018.07.003

Cited by 6 publications

(8 citation statements)

References 17 publications

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“…This was not the case of our patient who had sustained severe hypertension associated with the classic symptoms of pheochromocytoma (palpitation, sweating, and hot flashes), hypokalemia, and a secondary diabetes mellitus. In our case, as reported in the literature [ 16 , 17 ], a remarkable remission of diabetes mellitus and an improvement of lipid profile were noticed after tumor removal confirming the secondary character of these two metabolic disorders. In fact, catecholamine excess affects insulin secretion, decreased glucose uptake in the peripheral tissues, and increased insulin resistance leading to impaired fasting glucose or overt diabetes mellitus [ 18 ].…”

Section: Discussionsupporting

confidence: 88%

“…In most published cases, the mean age at presentation was about 30 years, but very young cases have been described, the youngest before 5 years [ 7 , 10 ]. In addition, VHL-associated pheochromocytomas are less likely to be associated with symptoms or biochemical evidence of catecholamines production compared with those occurring in patients without VHL [ 16 , 17 ]. In a report of the National Institute of Health about 64 patients with VHL disease and pheochromocytomas, a total of 106 tumors were identified.…”

Section: Discussionmentioning

confidence: 99%

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A Case of Von Hippel–Lindau Disease with Bilateral Pheochromocytoma and Ectopic Hypersecretion of Intact Parathyroid Hormone in an Adolescent Girl

Belaid

Oueslati

Chihaoui

et al. 2020

Case Reports in Endocrinology

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Von Hippel–Lindau disease is an autosomal dominant inherited syndrome predisposing to a variety of highly vascularised tumors in different organs. Although bilateral pheochromocytoma was reported in patients with von Hippel–Lindau disease, the coexistence of primary hyperparathyroidism is not a common condition. We report an observation of a primary hyperparathyroidism secondary to an ectopic secretion of intact parathyroid hormone in a 17-year-old girl with von Hippel–Lindau disease and bilateral pheochromocytoma. She presented with a newly diagnosed diabetes mellitus and a severe arterial hypertension. Blood tests disclosed hypercalcemia with increased intact PTH level. Cervical ultrasound and sestamibi scintigraphy were normal. Twenty-four-hour urinary normetanephrine level was highly elevated pointing to a catecholamine-secreting tumor. The abdominal computed tomography showed bilateral adrenal masses. MIBG scintigraphy exhibited a high accumulation of the tracer in both adrenal tumors. Genetic testing revealed a mutation of the VHL gene. The patient underwent a bilateral adrenalectomy. The postoperative outcome was marked by normalization of blood pressure, blood glucose, calcium, and PTH levels. In our case, the elevation of intact PTH and its spontaneous normalization after surgical treatment of pheochromocytomas confirms its ectopic secretion.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

A Case of Von Hippel–Lindau Disease with Bilateral Pheochromocytoma and Ectopic Hypersecretion of Intact Parathyroid Hormone in an Adolescent Girl

Belaid

Oueslati

Chihaoui

et al. 2020

Case Reports in Endocrinology

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“…2019 18 36 IU insulin (insulin detemir 24 IU/day, insulin aspart 12 IU TID) None Left, unilateral and benign SDH-A gene Cha J, et al. 2018 19 154 IU insulin (insulin glargine 68 IU/day, insulin aspart 28 IU TID) None Left, unilateral and benign SDH-B gene Mesmar B, et al. 2017 15 Case 1: Insulin 45 IU/day Metformin Left, unilateral and benign No genetic testing was performed Case 2: Insulin 70 IU/day Metformin + glipizide Left, unilateral and benign Hirai H, et al.…”

Section: Discussionmentioning

confidence: 99%

Surgical Remission of Diabetes in a Patient With Mutation of RET Proto-Oncogene

Concepción-Zavaleta

Flórez

Moya

et al. 2021

AACE Clinical Case Reports

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…Several case reports have reported cardiomyopathy [ 4 – 6 ], pulmonary edema [ 7 ], and hyperglycemia [ 8 ] as isolated complications of pheochromocytoma. However, the concomitant presence of all these complications along with multi-organ failure made the diagnosis and management particularly challenging in this patient.…”

Section: Discussionmentioning

confidence: 99%

Catecholamine-induced cardiomyopathy and multiple organ failure in pheochromocytoma

Thekekara

Gunasekharan

Kwon

et al. 2020

Journal of Community Hospital Internal Medicine Perspectives

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A 55-year-old Caucasian woman with no significant past medical history presented with chest pain, palpitations, shortness of breath, and nausea. Physical examination was notable for a blood pressure of 182/87 mmHg, heart rate (HR) of 74 beats per minute (bpm), temperature of 98.3ºF, and oxygen saturation of 94% on 15 liters (L) of oxygen per minute. Her initial labs revealed troponin of 0.26 ng/mL (<0.01 ng/mL), blood glucose of 497 mg/dL (70-99 mg/dL), lactic acid of 6.9 mmol/L (0.4-1.9 mmol/L), and white blood cell (WBC) of 21.6 K/uL (4-11.0 K/ uL). EKG showed ST elevation in leads V1 and V2. CT Pulmonary angiography with contrast ordered to rule out pulmonary embolism revealed a right adrenal mass measuring 3.5 cm x 4.1 cm. Patient was admitted to the intensive care unit for ST elevation myocardial infarction, hyperglycemia, and sepsis. She was started on heparin, broad-spectrum antibiotics, intravenous fluids, and insulin. Emergent echocardiogram revealed 40-45% ejection fraction with septal, lateral, anteroseptal, and posterolateral hypokinesis. Troponin elevation to 1.00 ng/mL (<0.01 ng/mL) warranted a cardiac angiography which revealed new-onset systolic heart failure with reduced ejection fraction with normal coronary vessels. A relatively rapid improvement in her clinical course suggested that a functioning tumor could be the underlying etiology. Diagnostic work-up for pheochromocytoma showed elevated metanephrine and normetanephrine. Subsequent surgical biopsy of the adrenal mass was consistent with pheochromocytoma. It was a rare case presentation of pheochromocytoma with catecholamine-induced cardiomyopathy and multiple organ failure.

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Case of reversible diabetes mellitus in the setting of benign pheochromocytoma

Cited by 6 publications

References 17 publications

A Case of Von Hippel–Lindau Disease with Bilateral Pheochromocytoma and Ectopic Hypersecretion of Intact Parathyroid Hormone in an Adolescent Girl

A Case of Von Hippel–Lindau Disease with Bilateral Pheochromocytoma and Ectopic Hypersecretion of Intact Parathyroid Hormone in an Adolescent Girl

Surgical Remission of Diabetes in a Patient With Mutation of RET Proto-Oncogene

Catecholamine-induced cardiomyopathy and multiple organ failure in pheochromocytoma

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