Phaeochromocytoma presenting with coexisting acute renal failure, acidosis and in hyperglycaemic emergency

摘要

Phaeochromocytoma is a relatively uncommon tumour of the adrenal medulla, and its association with sustained or paroxysmal hypertension has also been labelled 'the great mimic', with a variety of typical or non-typical clinical manifestations.1 Reversible acute renal failure, although rare, can be the presenting symptom of phaeochromocytoma as a consequence of renal ischaemia due to systemic shock, vasoconstriction, tumour compression of the renal artery or hypoperfusion/acute tubular necrosis following hypotension. Hyperglycaemia and ketoacidosis have also been reported. The present study presents a case of phaeochromocytoma with coexisting acute renal failure, hyperglycaemia and acidosis.In October 2006, a 36-year-old man with no prior history of renal disease or hypertension attended the emergency room complaining of a two-day history of fever, nausea, vomiting, palpitations, sweating and anuria (12 hours). Medical history, social history and family history were non-contributory and the patient was not on medication.