METHODS: We report a case of pheochromocytoma initially presenting with cortical blindness secondary to posterior reversible encephalopathy syndrome and thrombotic microangiopathy from malignant hypertension. Our patient was seen in our facility less than a week prior to this manifestation and discharged after an unremarkable coronary ischemia work-up. In the outpatient setting, she had been prescribed multiple anti-hypertensives with remarkably elevated blood pressure throughout her hospitalization history.
CONCLUSIONS: Pheochromocytoma presenting with malignant hypertension and hypertensive encephalopathy should be expected if left untreated; nonetheless, the precipitation of cortical blindness is rare in the literature. This case contributes an additional vignette to the growing literature revolving adrenal tumors and their symptomatic presentation along with complex management. It also serves to promote increased diagnostic suspicion among clinicians upon evaluating patients with refractory hypertension.
方法:我们报告一例嗜铬细胞瘤,最初表现为皮质盲,继发于后部可逆性脑病综合征和恶性高血压血栓性微血管病。在这种表现前不到一周,我们的患者在我们的设施中被发现,并在不明显的冠状动脉缺血检查后出院。在门诊环境中,在她的整个住院历史中,她服用了多种降压药物,血压显著升高.
结论:嗜铬细胞瘤表现为恶性高血压和高血压性脑病,如果不及时治疗,皮质盲的沉淀在文献中很少见。这种情况为越来越多的有关肾上腺肿瘤及其症状表现以及复杂管理的文献提供了额外的插图。在评估难治性高血压患者时,它还可以促进临床医生对诊断的怀疑。