Multiple Organ Failure (MOF) in a Patient with Pheochromocytoma

 

Precipitating event: hemorrhagic necrosis of the tumor with a massive release of catecholamines

 

Signs and symptoms:

(1) hypotension

(2) headache

(3) sweating

(4) tachycardia with palpitations

(5) pallor with cold extremities

(6) nervousness and/or tremor

(7) acute abdominal pain with or without chest pain

(8) fatigue

(9) nausea and vomiting

(10) rhinitis

(11) afebrile

 

The absence of hypertension is a common reason why the diagnosis is not considered.

 

Multiple organ failures may include:

(1) renal failure

(2) respiratory failure

(3) pancreatitis

(4) lactic acidosis

(5) disseminated intravascular coagulopathy (DIC)

(6) rhabdomyolysis

(7) hepatic failure

 

The patient often is hemodynamically stable and does need vasopressor or inotropic support.

 

Differential diagnosis:

(1) septic shock

(2) stimulant overdose

(3) fulminant viral infection