Pancreatitis as the first manifestation of multiple endocrine neoplasia type 2A

Dora, José Miguel Silva; Siqueira, Débora Rodrigues; Meyer, Erika Laurini de Souza; Puñales, Márcia Khaled; Maia, Ana Luiza Silva

doi:10.1590/s0004-27302008000800021

Cited by 2 publications

(2 citation statements)

References 12 publications

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“…Pain surfacing as acute pancreatitis-like syndrome in the presence of chaotic clinical findings similar to those found in our case may be the first manifestation of a pheochromocytoma (PCC) [10, 11], a catecholamine-secreting tumor, originating within the adrenal medullary chromaffin system [12]. However, the levels of catecholamines in 24-h urine collection, specifically metanephrines [13], were normal in our case.…”

Section: Discussionsupporting

confidence: 58%

“Unclassical” Combination of Smell Dysfunction, Altered Abdominal Nociception and Human Hypertension Associated “Classical” Adrenal-Augmentation

2015

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We report a 33-year-old female patient, who arrived to the emergency ward with an abdominal pain that suddenly started 10 days before admission. Simultaneously, the patient developed sudden arterial hypertension and smell disturbances. Conventional medical treatment for pain and arterial hypertension was effortless. Laboratory tests ruled out pancreatitis. Metanephrines in her urine were also normal. A dual-phase intravenous contrast computed tomography of the abdomen showed a large mass within left adrenal gland. Adrenocortical adenoma was diagnosed. The mass was not hypervascularized but positive for synaptophysin and chromogranin A. Importantly, these proteins are heavily involved with acetylcholine metabolism. The triad of olfactory disorders, pain and arterial hypertension normalized after surgically extracting the adrenal mass. To our knowledge, this medical case is the first reported patient exhibiting immediate recovery of such unclassical triad of local and remote findings. The function and dysfunction of key nanocholinergic pathways involved with smell, blood pressure and nociception would explain the pathophysiology of this unique medical case.

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Section: Discussionsupporting

confidence: 58%

“Unclassical” Combination of Smell Dysfunction, Altered Abdominal Nociception and Human Hypertension Associated “Classical” Adrenal-Augmentation

2015

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“…Other, NOS category is for identified causes of hypercalcemia such as parathyroid tumors (43), multiple endocrine neoplasia (MEN) type 1 or 2a (33,44), other cancers such as multiple myeloma (33,45), or rare causes of hypercalcemia.…”

Section: Toxic-metabolic Factorsmentioning

confidence: 99%

Pancreatitis: TIGAR-O Version 2 Risk/Etiology Checklist With Topic Reviews, Updates, and Use Primers

Whitcomb

2019

Clin Transl Gastroenterol

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The Toxic-metabolic, Idiopathic, Genetic, Autoimmune, Recurrent and severe acute pancreatitis and Obstructive (TIGAR-O) Pancreatitis Risk/Etiology Checklist (TIGAR-O_V1) is a broad classification system that lists the major risk factors and etiologies of recurrent acute pancreatitis, chronic pancreatitis, and overlapping pancreatic disorders with or without genetic, immunologic, metabolic, nutritional, neurologic, metaplastic, or other features. New discoveries and progressive concepts since the 2001 TIGAR-O list relevant to understanding and managing complex pancreatic disorders require an update to TIGAR-O_V2 with both a short (S) and long (L) form. The revised system is designed as a hierarchical checklist for health care workers to quickly document and track specific factors that, alone or in combinations, may contribute to progressive pancreatic disease in individual patients or groups of patients and to assist in treatment selection. The rationale and key clinical considerations are summarized for each updated classification item. Familiarity with the structured format speeds up the completion process and supports thoroughness and consideration of complex or alternative diagnoses during evaluation and serves as a framework for communication. The structured approach also facilitates the new health information technologies that required high-quality data for accurate precision medicine. A use primer accompanies the TIGAR-O_V2 checklist with rationale and comments for health care workers and industries caring for patients with pancreatic diseases.

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Pancreatitis as the first manifestation of multiple endocrine neoplasia type 2A

Cited by 2 publications

References 12 publications

“Unclassical” Combination of Smell Dysfunction, Altered Abdominal Nociception and Human Hypertension Associated “Classical” Adrenal-Augmentation

“Unclassical” Combination of Smell Dysfunction, Altered Abdominal Nociception and Human Hypertension Associated “Classical” Adrenal-Augmentation

Pancreatitis: TIGAR-O Version 2 Risk/Etiology Checklist With Topic Reviews, Updates, and Use Primers

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