Hypertensive Crisis in a Patient With a Functioning Mesenteric Paraganglioma: Dramatic Response to Octreotide Treatment.

Autor:	Elshafie OT; Department of Endocrinology, Sultan Qaboos Comprehensive Cancer Care and Research Centre (SQCCCRC), Muscat, Sultanate of Oman., Bou Khalil AC; Department of Endocrinology, Sultan Qaboos Comprehensive Cancer Care and Research Centre (SQCCCRC), Muscat, Sultanate of Oman., Alshaibi MA; Department of Surgery, Sultan Qaboos Comprehensive Cancer Care and Research Centre (SQCCCRC), Muscat, Sultanate of Oman., Itkin BL; Department of Medical Oncology, Sultan Qaboos Comprehensive Cancer Care and Research Centre (SQCCCRC), Muscat, Sultanate of Oman., Ismail BM; Department of Pathology, Sultan Qaboos Comprehensive Cancer Care and Research Centre (SQCCCRC), Muscat, Sultanate of Oman., Woodhouse NJ; Department of Endocrinology, Sultan Qaboos Comprehensive Cancer Care and Research Centre (SQCCCRC), Muscat, Sultanate of Oman.
Jazyk:	angličtina
Zdroj:	AACE clinical case reports [AACE Clin Case Rep] 2023 May 09; Vol. 9 (5), pp. 149-152. Date of Electronic Publication: 2023 May 09 (Print Publication: 2023).
DOI:	10.1016/j.aace.2023.05.003
Abstrakt:	Background/objective: To report a dramatic and immediate clinical and biochemical response during treatment with octreotide in a patient with a functioning mesenteric paraganglioma (PGL). Case Report: A 44-year-old woman was admitted with a severe hypertensive crisis and a blood pressure reaching 260/150 mm Hg. She was 2 months postpartum and had been previously diagnosed with pre-eclampsia. Secondary hypertension was suspected. This was confirmed by finding a 6 × 5-cm 2 retroperitoneal mass located using 68-Gallium DOTA-octreotate positron emission tomography/computed tomography and a grossly elevated plasma catecholamine level of 93 000 pmol/L (normal reference range: 650-2433 pmol/L). Treatment was immediately started with high doses of long- and short-acting octreotide. After 6 weeks and before surgery, the patient was normotensive, with a blood pressure of 120/70 mm Hg and a norepinephrine level of 6000 pmol/L. The tumor resection was uneventful, and histology confirmed the diagnosis. Following the surgery, the patient remained normotensive without any medications. Discussion: PGLs and pheochromocytomas are neuroendocrine tumors, and most have receptors for octreotide. This case and another patient previously reported responded dramatically to treatment with a high dose of octreotide. Earlier reports of patients failing to respond are likely to have been the result of using a smaller octreotide dose. Conclusion: We conclude that high doses of short- and long-acting octreotide are valuable in severely hypertensive patients. Our experience suggests that octreotide is of value in other patients with PGLs and pheochromocytomas. The response is rapid, sustained, effective, and with minimal reported side effects. To the best of our knowledge, this is the first report of a hypertensive crisis in a functional mesenteric PGL. Competing Interests: The authors have no multiplicity of interest to disclose. (© 2023 AACE. Published by Elsevier Inc.)
Databáze:	MEDLINE
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