Pheochromocytoma and pregnancy: a case report and review of anesthetic management

Dugas, Geoff; Fuller, John; Singh, Sudha; Watson, James T.

doi:10.1007/bf03018772

Cited by 51 publications

(52 citation statements)

References 17 publications

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“…These include increases in intraabdominal pressure, fetal movement, uterine contraction, process of delivery, an abdominal surgical intervention, and even general anesthesia. 2,4,5 In our small series, only 1 patient presented with "typical" presentation features of the disorder, which is paroxysmal hypertension, associated with headaches, sweating, and tachycardia. Two patients were diagnosed initially with gestational diabetes, which, in these cases, may have been explained by the effect of the excess catecholamines on glucose metabolism by inhibition of insulin secretion or by induction or aggravation of insulin resistance.…”

Section: Discussionmentioning

confidence: 70%

Pheochromocytoma in Pregnancy

et al. 2010

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Section: Discussionmentioning

confidence: 70%

Pheochromocytoma in Pregnancy

et al. 2010

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“…Cesarean section and simultaneous removal of the tumor is the recommended approach [135]. Anesthetic management for this situation is discussed in detail in the article by Dugas and colleagues [136].…”

Section: Pheochromocytoma In Pregnancymentioning

confidence: 99%

Emergencies Caused by Pheochromocytoma, Neuroblastoma, or Ganglioneuroma

Brouwers

Eisenhofer

Lenders

et al. 2006

Endocrinology and Metabolism Clinics of North America

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This article reviews emergency situations caused by diseases of the sympathetic nervous system. Pheochromocytoma is discussed first and most extensively, because there are numerous reports in the literature on patients with (unsuspected) pheochromocytoma presenting as an emergency. Two other tumors of the sympathetic nervous system are then discussed that less commonly result in endocrine emergencies: neuroblastoma and ganglioneuroma. PheochromocytomaParagangliomas are rare catecholamine-producing tumors derived from chromaffin cells that can be fatal if left undiagnosed.

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“…This correlation is explained by the findings of Venkatesha et al who demonstrated that soluble endoglin acts by antagonizing an angiogenic molecule known as transforming growth factor beta-1, which is important in mediating nitric oxide-dependent vasodilatation and in keeping the lining of blood vessels healthy 25 Therefore, excess secretion of soluble endoglin leads to severe vasoconstriction, with resulting hypertension, and leakage of proteins into the tissues and urine. 26,27 Experimental evidence further supports the contribution of soluble endoglin to the pathogenesis of preeclampsia.…”

Section: Discussionmentioning

confidence: 97%

Correlation of serum soluble endoglin to the severity of pre-eclampsia and its effect on the pregnancy outcome

El-Dayem

El-Agwany

Khamis

et al. 2016

Int J Reprod Contracept Obstet Gynecol

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Background: Preeclampsia is a major obstetric problem and a significant source of maternal and neonatal morbidity and mortality. Preeclampsia is associated with increased risks of placental abruption, acute renal failure, cerebrovascular and cardiovascular complications, disseminated intravascular coagulation, and maternal death. Consequently, early diagnosis of preeclampsia and close observation are imperative. In these cases of preeclampsia, combination of Doppler flowmetry and circulating angiogenic factors levels are recorded. Stepan et al examined endoglin, a cell-surface co-receptor for transforming growth factor in patients with Doppler flow patterns of preeclampsia at 19-24 weeks. Soluble endoglin levels were elevated in second trimester pregnancies with abnormal uterine perfusion in women who experienced preeclampsia. The aim of this study was to test if there is correlation between the level of serum endoglin in pregnant women with severe preeclampsia to the maternal and fetal outcome. Methods: This study was conducted on a group of 90 pregnant women attended to the Antenatal clinic and selected from the preeclampsia unit of EL-Shatby Maternity University Hospital, The selected patients were subdivided in two groups. Group A (control group): 30 cases of normotensive pregnant ladies. Group B (case group): 60 cases of severe preeclamptic pregnant ladies. Routine investigations, maternal serum soluble endoglin and ultrasound results were analysed and compared for both groups. Results: Significant correlation was found between severe preeclampsia and high level soluble endoglin. Significant correlation was found between high level of soluble endoglin and the occurrence of IUGR among the severe preeclamptic patients. Positive correlation was found between serum level of soluble endoglin and uterine artery PI and uterine artery RI, the higher the serum level of soluble endoglin the higher the uterine artery pulsatility and resistance index. Significant correlation was found between high level of soluble endoglin and the occurrence of specific complications, the higher the level of soluble endoglin the higher the risk of exposure to preeclampsia complications as the occurrence of eclamptic fits, the development of HELLP syndrome, the admission to the ICU, the admission of the baby to the NICU, and the fetal death. Conclusions: From our study, it is evident that serum endoglin rises during normal as well as preeclamptic pregnancy and that the rise in preeclampsia is much higher, the rise in endoglin levels may occur as early as the first trimester in pregnancies which later develop preeclampsia. Hence, used alone or in combination with uterine artery Doppler flowmetry, the measurement of soluble serum endoglin has the potential for use as a predictive clinical test for preeclampsia risk assessment and could potentially improve the outcome of pregnancy.

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Pheochromocytoma and pregnancy: a case report and review of anesthetic management

Cited by 51 publications

References 17 publications

Pheochromocytoma in Pregnancy

Pheochromocytoma in Pregnancy

Emergencies Caused by Pheochromocytoma, Neuroblastoma, or Ganglioneuroma

Correlation of serum soluble endoglin to the severity of pre-eclampsia and its effect on the pregnancy outcome

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