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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Suspected Pheochromocytoma in a Patient With Guillain-Barre Syndrome
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Suspected Pheochromocytoma in a Patient With Guillain-Barre Syndrome

机译：格林巴利综合征患者疑似嗜铬细胞瘤

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Autonomic instability is well recognized in Guillain-Barre syndrome (GBS), particularly in the acute inflammatory demyelinating polyneuropathy subtype. Hypertension occurs in up to two-thirds of children with GBS but is rarely the main presenting feature. We describe a teenager who presented with tachycardia, dizziness, flushing, and significant hypertension as well as ascending limb weakness and sensory disturbance with areflexia. Because the predominant initial concern was hypertension, she was referred to pediatric nephrology and appropriate investigations for hypertension were conducted. Her neurologic findings prompted a neurology referral, and a diagnosis of GBS was made. The investigations for hypertension subsequently revealed increased urinary normetadrenaline levels in a range consistent with pheochromocytoma, prompting the question of dual pathology. Both autonomic symptoms and urinary metadrenaline levels subsided with GBS resolution, and further investigations excluded the diagnosis of pheochromocytoma. Our case highlights that significant dysautonomia can occur in children with GBS, with hypertension being a prominent early feature. Recognition that urinary metadrenalines can increase to levels seen in pheochromocytoma is important in avoiding diagnostic confusion. Pediatrics 2013;131:e955-e958
机译：在格林-巴利综合征（GBS）中，尤其是在急性炎症性脱髓鞘性多发性神经病亚型中，植物神经系统的不稳定性是公认的。高血压发生在多达三分之二的GBS儿童中，但很少是主要表现。我们描述了一名表现为心动过速，头晕，潮红和严重高血压以及肢体无力和肢体反射障碍的感觉障碍的青少年。由于最初的主要关注点是高血压，因此她被转到了儿科肾脏病科，并对高血压进行了适当的检查。她的神经系统发现促使神经科转诊，并诊断出GBS。高血压的调查随后显示，尿中的去甲肾上腺素水平升高，与嗜铬细胞瘤一致，这引发了双重病理学问题。自主神经症状和尿中肾上腺素水平均随GBS消退而降低，进一步的研究排除了嗜铬细胞瘤的诊断。我们的病例表明，GBS患儿可能会出现严重的自主神经异常，其中高血压是其主要的早期特征。认识到尿中肾上腺素可以增加到嗜铬细胞瘤中所见的水平，对避免诊断混乱很重要。儿科2013; 131：e955-e958

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