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- Masahiro Nezu, Hiroaki Kobayashi, Masashi Shiozaki, Miho Katsumata, Soichi Takizawa, Toshiharu Tsutsui, Ikuo Nukui, Yoshihiro Miyashita, Toshio Oyama, and Masaharu Inoue.
- Department of Endocrinology and Diabetes, Yamanashi Prefectural Central Hospital, Japan.
- Intern. Med. 2021 Sep 1; 60 (17): 2825-2830.
AbstractA 46-year-old woman with exacerbating hemoptysis and dyspnea was diagnosed with diffuse alveolar hemorrhage (DAH). High doses of glucocorticoids were initiated, but afterward, paroxysmal hypertension (210/140 mmHg) with headache and abdominal pain appeared. A 50-mm left adrenal tumor with an intense uptake by iodine-123 metaiodobenzylguanidine scintigraphy and catecholamine hypersecretion revealed complication with pheochromocytoma. Because high doses of glucocorticoids, sometimes required for DAH, can provoke life-threatening paroxysmal hypertension in pheochromocytoma and paraganglioma (PPGL), our case suggests that PPGL needs to be recognized as the cause of DAH and should be detected with whole-body imaging before starting glucocorticoids.
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