Pheochromocytoma presenting as fever of unknown origin, a case report
Introduction: Pheochromocytoma is a generally benign neoplasm derived from chromaffin cells of the adrenal medulla. It is characterized by the production of large amounts of catecholamines and also by the capacity to secrete bioactive peptides such as cytokines, mainly interleukin-1 (IL-1), interle...
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Universidad Nacional de Colombia
2020-07-01
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| Series: | Case Reports |
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| Online Access: | https://revistas.unal.edu.co/index.php/care/article/view/84240 |
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| author | Angélica María González-Clavijo Juan David Muñoz-Loaiza Jennifer Daniela Guzmán-Rojas Johiner Jahir Vanegas-Antolinez Laura Natalia Bermúdez-Silva Luis Felipe Fierro-Maya |
| author_facet | Angélica María González-Clavijo Juan David Muñoz-Loaiza Jennifer Daniela Guzmán-Rojas Johiner Jahir Vanegas-Antolinez Laura Natalia Bermúdez-Silva Luis Felipe Fierro-Maya |
| author_sort | Angélica María González-Clavijo |
| collection | DOAJ |
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Introduction: Pheochromocytoma is a generally benign neoplasm derived from chromaffin cells of the adrenal medulla. It is characterized by the production of large amounts of catecholamines and also by the capacity to secrete bioactive peptides such as cytokines, mainly interleukin-1 (IL-1), interleukin-6 (IL-6) and TNF alpha.
Case presentation: 24-year-old man, who consulted for fever, myalgia, and choluria. His laboratory tests were compatible with a systemic inflammatory response without infectious or autoimmune causes. However, a fluorodeoxyglucose positron emission tomography (FDGPET) revealed a left adrenal mass, without extra-adrenal lesions. On admission, increased levels of differentiated urine methanephrines, elevated baseline cortisol, non-suppressed adrenocorticotrophic hormone (ACTH), and positive low dose dexamethasone suppression test for cortisol were found. With suspicion of catecholamine and ACTH-producing pheochromocytoma, a tumor resection was performed, which conspicuously resolved all alterations of the inflammatory response. The histologic findings confirmed a pheochromocytoma, but the immunostaining for ACTH was negative. A literature review and the comparison of the findings with other reported cases allowed inferring that this was a case of interleukin-producing pheochromocytoma.
Conclusion: Pheochromocytoma may be a cause of febrile syndrome, with IL-6 being the main mediator, which explains the manifestationsof systemic inflammation and ACTH-mediated hypercortisolism.
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| format | Article |
| id | doaj-art-39ba62e2f0ee411296c2267cdc1e4f52 |
| institution | Kabale University |
| issn | 2462-8522 |
| language | English |
| publishDate | 2020-07-01 |
| publisher | Universidad Nacional de Colombia |
| record_format | Article |
| series | Case Reports |
| spelling | doaj-art-39ba62e2f0ee411296c2267cdc1e4f522024-11-26T23:59:01ZengUniversidad Nacional de ColombiaCase Reports2462-85222020-07-016210.15446/cr.v6n2.84240Pheochromocytoma presenting as fever of unknown origin, a case reportAngélica María González-Clavijo0https://orcid.org/0000-0003-4745-0474Juan David Muñoz-Loaiza1https://orcid.org/0000-0003-1263-2147Jennifer Daniela Guzmán-Rojas2https://orcid.org/0000-0001-5484-4944Johiner Jahir Vanegas-Antolinez3https://orcid.org/0000-0002-2795-8847Laura Natalia Bermúdez-Silva4https://orcid.org/0000-0002-1868-7766Luis Felipe Fierro-Maya5https://orcid.org/0000-0003-1661-6574Universidad Nacional de Colombia - Bogotá Campus - Faculty of Medicine - Department of Physiological Sciences - Bogotá D.C. - ColombiaUniversidad Nacional de Colombia - Bogotá Campus - Faculty of Medicine - Department of Physiological Sciences - Bogotá D.C. - ColombiaUniversidad Nacional de Colombia - Bogotá Campus - Faculty of Medicine - Department of Physiological Sciences - Bogotá D.C. - ColombiaUniversidad Nacional de Colombia - Bogotá Campus - Faculty of Medicine - Department of Physiological Sciences - Bogotá D.C. - ColombiaUniversidad Nacional de Colombia - Bogotá Campus - Faculty of Medicine - Department of Physiological Sciences - Bogotá D.C. - ColombiaInstituto Nacional de Cancerología - Department of Endocrinology - Bogotá D.C. - Colombia Introduction: Pheochromocytoma is a generally benign neoplasm derived from chromaffin cells of the adrenal medulla. It is characterized by the production of large amounts of catecholamines and also by the capacity to secrete bioactive peptides such as cytokines, mainly interleukin-1 (IL-1), interleukin-6 (IL-6) and TNF alpha. Case presentation: 24-year-old man, who consulted for fever, myalgia, and choluria. His laboratory tests were compatible with a systemic inflammatory response without infectious or autoimmune causes. However, a fluorodeoxyglucose positron emission tomography (FDGPET) revealed a left adrenal mass, without extra-adrenal lesions. On admission, increased levels of differentiated urine methanephrines, elevated baseline cortisol, non-suppressed adrenocorticotrophic hormone (ACTH), and positive low dose dexamethasone suppression test for cortisol were found. With suspicion of catecholamine and ACTH-producing pheochromocytoma, a tumor resection was performed, which conspicuously resolved all alterations of the inflammatory response. The histologic findings confirmed a pheochromocytoma, but the immunostaining for ACTH was negative. A literature review and the comparison of the findings with other reported cases allowed inferring that this was a case of interleukin-producing pheochromocytoma. Conclusion: Pheochromocytoma may be a cause of febrile syndrome, with IL-6 being the main mediator, which explains the manifestationsof systemic inflammation and ACTH-mediated hypercortisolism. https://revistas.unal.edu.co/index.php/care/article/view/84240PheochromocytomaFever of Unknown OriginInterleukin-6 |
| spellingShingle | Angélica María González-Clavijo Juan David Muñoz-Loaiza Jennifer Daniela Guzmán-Rojas Johiner Jahir Vanegas-Antolinez Laura Natalia Bermúdez-Silva Luis Felipe Fierro-Maya Pheochromocytoma presenting as fever of unknown origin, a case report Case Reports Pheochromocytoma Fever of Unknown Origin Interleukin-6 |
| title | Pheochromocytoma presenting as fever of unknown origin, a case report |
| title_full | Pheochromocytoma presenting as fever of unknown origin, a case report |
| title_fullStr | Pheochromocytoma presenting as fever of unknown origin, a case report |
| title_full_unstemmed | Pheochromocytoma presenting as fever of unknown origin, a case report |
| title_short | Pheochromocytoma presenting as fever of unknown origin, a case report |
| title_sort | pheochromocytoma presenting as fever of unknown origin a case report |
| topic | Pheochromocytoma Fever of Unknown Origin Interleukin-6 |
| url | https://revistas.unal.edu.co/index.php/care/article/view/84240 |
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