Continuous renal replacement therapy for haemodynamic collapse and rhabdomyolysis induced by pheochromocytoma crisis

Abstract

Pheochromocytoma associated with pregnancy is not common. Caesarean section may induce pheochromocytoma crisis, resulting in a lethal condition. The clinical picture of pheochromocytoma crisis is extremely variable. In this report, we describe a case of severe pheochromocytoma crisis induced by caesarean section presenting with hyperpyrexia, haemodynamic collapse, muscle weakness, heart failure, and acute kidney injury. Furthermore, we report that the muscle weakness was a manifestation of rhabdomyolysis, resulting from the pheochromocytoma crisis. Standard medical therapy failed to halt the patient's rapidly deteriorating condition. Continuous renal replacement therapy removed catecholamines from the circulation, resulting in improvement of haemodynamics and abrogation of rhabdomyolysis.

Continuous Renal Replacement Therapy for Hypertension Complicated by Refractory Heart Failure: An Analysis of Safety and Nursing Highlights

“…At the same time, CRRT has the characteristics of favorable safety, high tolerance in patients, and high success rate of treatment and is simple to operate and can be implemented at the bedside, especially for critically ill patients [ 26 ]. It is pointed out that the long duration of routine hemodialysis has a great influence on hemodynamics and even the therapeutic effect and may cause arrhythmia, hypotension, and even aggravation of HF and other ARs [ 27 ]. This is also consistent with our findings, indicating that CRRT is more suitable for the treatment of RHF.…”

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

“…Pheochromocytoma is a rare catecholamine secreting tumor, occurring in less than 0.5% of patients with hypertension [4], which classically presents with hypertension, headache, palpitations, sweating, and diaphoresis. It can, however, rarely have more dramatic presentations, including cardiogenic shock [5,6], myocardial infarction [7], cardiomyopathy [8], rhabdomyolysis [9][10][11][12], acute renal failure [5,[13][14][15][16], pulmonary haemorrhage [7], arrhythmia, and microangiopathic hemolysis [13,14,17]. An acute and severe presentation of pheochromocytoma involving end organ damage or dysfunction brought on by catecholamine-induced hemodynamic instability is referred to as a pheochromocytoma crisis (PCC).…”