The measurement of urine catecholamine and metanephrine concentrations is important for biochemical screening and diagnosis of pheochromocytoma.The goal of this work was to develop a simple liquid chromatography-tande...The measurement of urine catecholamine and metanephrine concentrations is important for biochemical screening and diagnosis of pheochromocytoma.The goal of this work was to develop a simple liquid chromatography-tandem mass spectrometry(LC-MS/MS)method for determining catecholamines and metanephrines in urine to replace an existing liquid chromatographic method using electrochemical detection.Urine samples were prepared using Oasis weak-cation-exchange cartridges.The eluate was analyzed on an Agilent ZORBAX Eclipse Plus Phenyl-Hexyl column in 3 min.Adrenaline,noradrenaline,dopamine,metanephrine,normetanephrine,and their deuterated internal standards were monitored in positive electrospray ionization mode by multiple reaction monitoring(MRM).No evidence of ion suppression was observed.The assay was linear up to 5μmol/L for adrenaline,5μmol/L for noradrenaline,6.1μmol/L for dopamine,5.6μmol/L for metanephrine,and 34.6μmol/L for normetanephrine,with lower limits of quantification of 5,5,12,6 and 7nmol/L,respectively.The intra-day and inter-day precisions for all analytes ranged from 0.59%to 4.64%and1.98%to 4.80%,respectively.External quality assurance samples were assayed and showed excellent agreement with the target values.This simple method provides an improved assay for determining urine catecholamines and metanephrines.展开更多
Objective:To investigate the relationship between the levels of plasma adrenaline and norepinephrine and gene polymorphism ofβ1 adrenergic receptor G1165 C in children with enterovirus 71(EV71)infection in hand foot ...Objective:To investigate the relationship between the levels of plasma adrenaline and norepinephrine and gene polymorphism ofβ1 adrenergic receptor G1165 C in children with enterovirus 71(EV71)infection in hand foot and mouth disease(HFMD).Methods:The polymerase chain reaction(PCR)was used to detect the expression of gene polymorphism ofβ1 adrenergic receptor G1165 C in vitro.The levels of plasma adrenaline and norepinephrine were measured by enzyme-linked immunosorbent assay(ELISA).Results:The plasma norepinephrine level of severe group was significantly higher than the mild group in children with EV71 infection in HFMD(P<0.05);however,the levels of plasma adrenalinein in two groups had no statistical differences(P>0.05);There was no significant difference in the distribution ofβ1 adrenergic receptor G1165 C genotype and allele between EV71 infection group and healthy control group(P>0.05).Further analysis of EV71 infection group by dividing it into mild and severe groups showed that there was no significant difference in the distribution of genotype and allele between these two groups as well(P>0.05).There was no significant difference in the levels of epinephrine and norepinephrine in different genotypes of EV71 infection group(P>0.05),and in the levels of plasma epinephrine and norepinephrine in the mild and severe groups(P>0.05).Conclusions:As the disease gets worse,the plasma norepinephrine level has a rising trend in children with EV71 infection in HFMD,which is an important indicator to evaluate the progress of the disease.However,the gene polymorphism of eptor G1165 C have no significant correlation,not only with the susceptibility and severitβ1 adrenergic recy of EV71 infection in hand,foot and mouth disease,but also with the levels of catecholamine.展开更多
Objective.To compare the effects of alfentanil and esmolol on hemodynamic and catecholamine response to tracheal intubation. Methods.Thirty five adult patients were randomly allocated to on...Objective.To compare the effects of alfentanil and esmolol on hemodynamic and catecholamine response to tracheal intubation. Methods.Thirty five adult patients were randomly allocated to one of three groups,Group A(control group),Group B(esmolol group)and Group C(alfentanil group).The patients received either 2 mg/kg esmolol(in Group B)or 30 μg/kg alfentanil(in Group C)before intubation.Tracheal intubation was performed with 4 mg/kg thiopental and 0 1 mg/kg vecuronium and 3% isoflurane.Systolic blood pressure(SBP),diastolic blood pressure(DBP),mean blood pressure(MBP),heart rate(HR),norepinephrine(NE),epinephrine(E)and dopamine(DA)were measured before and after intubation. Results.The control group had a baseline SBP of 149±23 mmHg while Groups B,C had a baseline SBP of 148±23,and 150±21mmHg,respectively(P>0 05).Three min after tracheal intubation,the control group SBP increased to 160±30 mmHg and Group B remained at the baseline level,147±5 mmHg,and Group C significantly decreased to 91±22 mmHg(P<0 01).Two min after intubation HR in Group B increased significantly but 3 min after intubation HR in Groups B and C were significantly lower than that of control group(P<0 05).NE in Groups A and B increased significantly to 5 75±3 51 and 6 75±3 30 nmol/L 3 min after intubation(P<0 01).In Group C,3 min after intubation NE was not significantly different from the baseline but E decreased significantly(P<0 01). Conclusion.2 mg/kg esmolol can moderate the hemodynamic response to tracheal intubation to a certain extent and 30μg/kg alfentanil can completely attenuate the hemodynamic and catecholamine responses.展开更多
The role of catecholamine (CA) in the pathogenesis and development of macular edema of central serous chorioretinopathy (CSC) was studied, and its relations with visual acuity were investigated Plasma concentrations...The role of catecholamine (CA) in the pathogenesis and development of macular edema of central serous chorioretinopathy (CSC) was studied, and its relations with visual acuity were investigated Plasma concentrations of epinephrine (E) and norepinephrine (NE) were determined in 30 consecutive eyes with CSC Central macular thickness analysis was done by RTA and all the data were compared with normal eyes and analyzed with SAS software package Plasma concentrations of E and NE were increased to (569±123) ng/L and (721±104) ng/L respectively in active CSC patients, significantly higher than those in normal subjects ( P< 0 01), and decreased to normal in convalescent stage RTA analysis revealed that the retinal thickness of CSC patients was increased at active and recovery stage as compared with normal subjects; and the plasma concentration of E was significantly correlated with central macular thickness( t =2 173, P< 0 05) Also, central macular thickness measured by RTA was significantly correlated with the visual acuity ( r = -0 8046 , P< 0 001) in CSC eyes RTA analysis might be useful to quantitatively detect and evaluate prognosis in CSC patients The plasma concentration of E, which was highly correlated with macular edema, might play an important role in the early damage and the pathogenesis of CSC展开更多
A rapid and sensitive method for the analysis of three catecholamines by capillary electrophoresis （CE） with direct chemiluminescence （CL） detection is described. The detection limits （S/N= 3） were 1.3 × 10...A rapid and sensitive method for the analysis of three catecholamines by capillary electrophoresis （CE） with direct chemiluminescence （CL） detection is described. The detection limits （S/N= 3） were 1.3 × 10^-8 g/mL for isoprenaline, 1.0 × 10^-8g/mL for epinephrine and 2.8 × 10^-8 g/mL for dopamine. The proposed method was successfully applied to the analysis of catecholamines in urine samples of cigarette smokers and nonsmokers. The results showed that there is a close relation between the release of dopamine in human body fluids and cigarette smoking/nonsmoking.展开更多
Autosomal recessive mutations in the PARK7 gene,which encodes for the protein DJ-1,result in a loss of function and are a cause of familial Parkinson’s disease（PD）,while increased wild-type DJ-1protein levels are a...Autosomal recessive mutations in the PARK7 gene,which encodes for the protein DJ-1,result in a loss of function and are a cause of familial Parkinson’s disease（PD）,while increased wild-type DJ-1protein levels are associated with some forms of cancer.Several functions of DJ-1 have been described,with the greatest evidence indicating that DJ-1 is a redox-sensitive protein involved in the regulation of oxidative stress and cell survival.展开更多
The serum thyroid hormone and plasma catecholamine were examined in 18 male and 2 female members of the Chinese Antarctic Expedition (who spent the 2000 or 2001 austral winter at the Great Wall Station) . The changes ...The serum thyroid hormone and plasma catecholamine were examined in 18 male and 2 female members of the Chinese Antarctic Expedition (who spent the 2000 or 2001 austral winter at the Great Wall Station) . The changes of serum thyroid hormone i. e. total thyroxine (TT4) and free T4 (FT4) , total triodothyronine (TT3) and freeT3 ( FT3 ) , thyroid stimulating hormone ( TSH ) and plasma catecholamine, including norepinephrine (NE) , epinephrine ( E) and dopamine ( DA ) , were investigated by Chemoluminescence Immunoassay (CLIA) and High Performance Liquid Chromatography with electrochemical detection (HPLC-ECD) . Samples were taken at different time; (1)1 day before departure to Antarctica (16th expedition 1999/12/ 09; 17th expedition 2000/12/06). (2) 1 day after returned to China after living 54 weeks in Antarctica ( 16th expedition 2000/12/25 ; 17th expedition 2001/12/25 ). Comparing the data of before departure and returned, results showed that there was a significant decrease in the contents of TT4 (P <0. 01) with no significant change in the content of TT3 , FT3 and FT4. It was also found that the content of TSH increased significantly (P <0. 001) ; No significant changes of plasma NE and DA were found but the content of E decreased significantly ( P < 0. 001) . The results indicated that the special Antarctic environment led to a restrain effect on the thyroid function and the level of plasma E in Antarctic expedition members. Both the thyroid and adrenal medulla system were associated in response to the Antarctic systemic stress.展开更多
To study the effects of electroacupuncture on sympathetic adrenomedullary(SA) system and renin angiotensin aldosterone (RAA) system in open heart surgical patients undergoing cardiopulmonary bypass (CPB), 30 patients ...To study the effects of electroacupuncture on sympathetic adrenomedullary(SA) system and renin angiotensin aldosterone (RAA) system in open heart surgical patients undergoing cardiopulmonary bypass (CPB), 30 patients with atrial septal defect were randomly divided into general anesthesia (GA) group, acupuncture anesthesia (AA) group and acupuncture with general anesthesia (AGA) group. Peripheral blood samples were taken before anesthesia and 30 min after CPB. The plasma concentrations of norepinephrine (NE), epinphrine (E) and angiotensinⅡ(AⅡ) were detected. Results: Plasma NE and E of post CPB increased significantly in GA group and AA group, but decreased significantly in AGA group. Plasma AⅡ of post CPB increased significantly in GA group, but no marked changes were found in AA group and AGA group. Conclusions: Acupuncture can improve the AⅡ response to cardiac surgery and CPB. AGA but not AA can inhibit the catecholamine (CA) response to cardiac surgery and CPB.展开更多
Objective To investigate the stratification risk of catecholamines-β-adrenoceptor (β-AR)-cAMP pathway for cardiogenic death events in patients with congestive heart failure (CHF). Methods A total of 83 identified CH...Objective To investigate the stratification risk of catecholamines-β-adrenoceptor (β-AR)-cAMP pathway for cardiogenic death events in patients with congestive heart failure (CHF). Methods A total of 83 identified CHF patients with a baseline and follow-up plasma levels of norepinephrine (NE) and epinephrine (E), lymphocytes β-AR density (Bmax), and intralymphocyte cAMP content in peripheral blood were followed up. Major cardiogenic death events were registered. Results The period between the initial entry and the last follow-up measurement were 51±16 months, the total duration of clinical follow-up after the last measurement were 14±8 months. During follow-up, 39 patients died of cardiogenic (sudden death 17 patients, worsening heart failure 22 patients). Persistence of high NE, E, and cAMP from baseline to follow-up were confirmed as risk predicting factors of cardiovascular events. Persistence NE above 4.0 nmol/L, E above 3.5 nmol/L, and the intralymphocyte cAMP content above 3.5 pmd·mg-1·pro-1 from baseline to follow-up were significant adverse prognostic predictors. The major cardiogenic death events rates per 100 patients-years were 1.33 and 4.82 in patients with NE below and above 4.0 nmol/L (HR: 2.91; 95% CI: 1.08-7.33; P = 0.015); were 1.42 and 4.36 in the patients with E levels below and above 3.5 nmol/L (HR: 2.64; 95% CI: 1.02-6.41; P = 0.019); were 1.81 and 4.67 in the patients with the intralymphocyte cAMP content below and above 3.5 pmd·mg-1·pro-1 (HR: 2.79; 95% CI: 1.04-6.83; P = 0.017), but difference was not significant between the β-AR density below and above median. Conclusions Persistent increase in circulating catecholamines and intralymphocyte cAMP content may increase the long-term mortality in CHF patients.展开更多
A simple,fast,sensitive,highly selective and eco-friendly analytical method for the determination of catecholamines in human urine by ion chromatography（IC） with chemiluminescence（CL） detection was described in th...A simple,fast,sensitive,highly selective and eco-friendly analytical method for the determination of catecholamines in human urine by ion chromatography（IC） with chemiluminescence（CL） detection was described in this paper.Using 12 mmol/L H_2SO_4 without any organic additive as eluent,three catecholamines including epinephrine（EP）,norepinephrine（NE） and dopamine（DA） were well separated on a cation-exchange column.The CL detection was based on the reaction of analytes with acidic potassium permanganate in the presence of formaldehyde as an enhancer.The absence of methanol and acetonitrile in eluent made the proposed method more sensitive and eco-friendly.Under the optimal conditions,the linear range of the proposed method was in the range of 0.02-0.5μg/mL.The limit of detection（LOD） was in the range of 0.6 and 5.1μg/L.The relative standard deviations （RSD） for 0.1μg/mL mixed standard solution were in the range of 0.8-1.9%（n = 11）.The method has been applied to the determination of catecholamines in human urine successfully.Excellent spiked recoveries were achieved for catecholamines ranged from 91.2%to 112.7%.展开更多
Preconcentration of catecholamines by the modified monolithic silica in the capillary was investigated in this study. In order to achieve a microchip-based method for determining catecholamines in the saliva,the monol...Preconcentration of catecholamines by the modified monolithic silica in the capillary was investigated in this study. In order to achieve a microchip-based method for determining catecholamines in the saliva,the monolithic silica was fabricated in the capillary and the monolithic silica was chemically modified by on-column reaction with phenylboronate. Different modified methods were compared. The concentration conditions were optimized. This study indicates the applicability of the modified monolithic silica capillary when it was used to concentrate catecholamines.展开更多
Manganese is an essential metal in human that functions in many enzymes. In contrast excessive exposure to Mn results in neurotoxicity. Accumulation of manganese damages central nervous system and causes Parkinson dis...Manganese is an essential metal in human that functions in many enzymes. In contrast excessive exposure to Mn results in neurotoxicity. Accumulation of manganese damages central nervous system and causes Parkinson disease like syndrome called manganism. Mn neurotoxicity has been suggested to involve an imbalance in catecholamine neurotransmitters. It hypothesized that Mn can obstruct catecholamine synthesis pathway by inhibition of Tyrosine hydroxylase. Previous studies demonstrated that chronic and acute dose of Mn has different possible effects on catecholamine synthesis. It’s assumed that an acute dose of manganese can kill dopaminergic cells. Therefore, we focused the effect of Mn in catecholamine concentration on the rat’s brain by MnCl2 injection intraperitoneally and analyzed their brains after the time interval. This study used different acute doses in short time courses and different chronic doses at different exposing times to investigate which of them (exposing dose or time) is more important in Mn toxic effect. Measurement of catecholamine concentration performed by fluorescence assay in acidic and oxidant environment.展开更多
The objective of this review is to summarize current data obtained so far in catecholamine-essential hypertension(EH) relationships on a genetic basis. As the major elements driving the sympathetic system's action...The objective of this review is to summarize current data obtained so far in catecholamine-essential hypertension(EH) relationships on a genetic basis. As the major elements driving the sympathetic system's actions, catecholamines modulate a variety of physiological processes and mutations related to the system. This could generate serious disorders, such as severe mental illnesses, stress-induced disorders, or impairedcontrol of blood pressure or motor pathways. EH is idiopathic, and the genetic basis of its causes and substantial interindividual discrepancies in response to different types of treatments are the focus of interest. Susceptibility to disease or efficacy of treatments are thought to reflect genomic variabilities among individuals. Therefore, outlining the available knowledge in functional genetic polymorphisms linked to EH will make the picture clearer and will help to establish future prospects in the field.展开更多
Nitric oxide (NO) regulates a wide range of physiological processes. Recent studies show that NO can regulate the release of catecholamines (CA) from the adrenal medulla. In the current study, the PC12 cell line was u...Nitric oxide (NO) regulates a wide range of physiological processes. Recent studies show that NO can regulate the release of catecholamines (CA) from the adrenal medulla. In the current study, the PC12 cell line was used to examine the effect of NO on the regulation of the CA biosynthetic enzymes: tyrosine hydroxylase (TH), dopamine-β-hydroxylase (DBH) and phenylethanolamine Nmethyltransferase (PNMT). Treatment of PC12 cells with the NO donor, sodium nitroprusside (SNP) for 6 hours significantly increased TH, DBH and PNMT mRNA levels. In addition, NO potentiates the regulation of gene expression of all three CA biosynthetic enzymes by glucocorticoids and cholinergic agonists. The signaling pathways involved in NO regulation of CA biosynthetic enzymes were investigated with the use of specific kinase activators and inhibitors, with results supporting a contributing role of PKA, PKC and PKG in SNP-mediated induction for all three CA genes (p < 0.01). In addition, inhibitors of transcription and translation inhibited SNP-mediated induction of all three genes (p < 0.001) suggesting that both transcriptional and translational mechanisms may be involved in CA gene regulation by NO. Results from this study show that in addition to regulating CA biosynthetic enzymes, NO can also potentiate cholinergic and glucocorticoid activation of CA genes.展开更多
Objective: To observe changes of plasma catecholamine (CA) level in patients experiencing cholecystectomy under acupuncture anesthesia combined with epidural administration of small dose of anesthetics. Methods: 33 ch...Objective: To observe changes of plasma catecholamine (CA) level in patients experiencing cholecystectomy under acupuncture anesthesia combined with epidural administration of small dose of anesthetics. Methods: 33 cholecystectomy patients were randomly divided into acupuncture combined with epidural anesthesia (A) group (n=11), acupoint skin electrical stimulation combined with epidural anesthesia (B) group (n=11) and simple epidural anesthesia (C) group (n=11). Acupoints used were bilateral Zusanli (ST 36) and Neiguan (PC 6) and stimulated with parameters of frequency 2/15 Hz, intermittent waves, electric current 2～3 mA for group A and 13mA for group B. Extradural anesthetic administered was 1.5% Lidocaine 5 mL. Venous blood samples were collected one day before, during and 3 days after operation for detecting plasma NE, E and DA contents. Results: ① During operation, plasma NE of group A and B lowered in comparison with pre operation, particularly group A (P<0.01), while in group C, plasma NE level increased slightly; plasma E of group A and B increased significantly compared with pre operation (P< 0.01). Plasma DA in the 3 groups all raised during operation. ② Three days after operation, plasma NE, E and DA levels recovered basically in comparison with those of one day before operation. It indicates that acupuncture or acupoint skin electrical stimulation is capable of regulating sympathetic activity during epidural anesthesia. The anesthetic effect has a closer relation with changes of plasma NE level rather than changes of plasma E or DA levels. Conclusion: Acupuncture or acupoint surface electrical stimulation combined with epidural anesthesia may be of reducing or releasing surgical operation generated stress response during cholecystectomy.展开更多
Background:Caregivers of dementia patients have significantly higher levels of serum IL-6 and CRP compared to non-caregivers,and the accumulation of everyday stressors reportedly promotes the induction of inflam...Background:Caregivers of dementia patients have significantly higher levels of serum IL-6 and CRP compared to non-caregivers,and the accumulation of everyday stressors reportedly promotes the induction of inflammatory markers.However,few studies have identified factors that affect catecholamine levels in caregivers who experience a combination of physical and mental stress from caregiving.Purpose:This study aimed to identify physical factors that impact catecholamine levels in caregivers of dementia patients.Methods:Participants were elderly caregivers living together with elderly Alzheimer’s-type dementia patients.We performed logistic regression analysis,with levels of adrenaline,noradrenaline,and dopamine(indicators of catecholamine)as dependent variables.Results:Caregiver BMI had a significant impact on adrenaline levels(OR:0.792;95%CI:0.654-0.960)and noradrenaline levels(OR:1.210;95%CI:1.009-1.451),whereas age had a significant impact on dopamine levels(OR:1.162;95%CI:1.019-1.324).Discussion:While caregiver BMI significantly impacted adrenaline and noradrenaline levels,the mechanism underlying these relationships is unclear.One possibility is that obesity(BMI)and a rise in sympathetic nerve activity contributed to hypertension.Our findings suggest that chronic stress in elderly caregivers may potentially impair the dopaminergic activation system in the brain.Conclusion:There is a need to identify factors which increase BMI in caregivers.Future studies aimed at gaining a better understanding of the lifestyle habits of caregivers and intervention studies aimed at reducing their BMI are warranted.展开更多
A flow injection chemiluminescence (CL) method for the determination of catecholamines is described which is based on their inhibition of the intensity of CL from the luminol-hypochlorite system The hypochlorite was e...A flow injection chemiluminescence (CL) method for the determination of catecholamines is described which is based on their inhibition of the intensity of CL from the luminol-hypochlorite system The hypochlorite was electrogenerated on-line by a constant current electrolysis, resulting in the elimination of the instability of the hypochlorite solution prepared from a commercial reagent of sodium hypochlorite. The detection limits are 0.6 ng/ml for dopamine, 0.8 ng/ml for adrenaline and isoprenaline. The proposed method has been successfully applied to the determination of catecholamines in pharmaceutical injections.展开更多
Alzheimer's disease is a common neurodegenerative disorder in older adults.Despite its prevalence,its pathogenesis remains unclea r.In addition to the most widely accepted causes,which in clude excessive amyloid-b...Alzheimer's disease is a common neurodegenerative disorder in older adults.Despite its prevalence,its pathogenesis remains unclea r.In addition to the most widely accepted causes,which in clude excessive amyloid-beta aggregation,tau hyperphosphorylation,and deficiency of the neurotransmitter acetylcholine,numerous studies have shown that the dopaminergic system is also closely associated with the occurrence and development of this condition.Dopamine is a crucial catecholaminergic neurotransmitter in the human body.Dopamine-associated treatments,such as drugs that target dopamine receptor D and dopamine analogs,can improve cognitive function and alleviate psychiatric symptoms as well as ameliorate other clinical manifestations.Howeve r,therapeutics targeting the dopaminergic system are associated with various adverse reactions,such as addiction and exacerbation of cognitive impairment.This review summarizes the role of the dopaminergic system in the pathology of Alzheimer's disease,focusing on currently available dopamine-based therapies for this disorder and the common side effects associated with dopamine-related drugs.The aim of this review is to provide insights into the potential connections between the dopaminergic system and Alzheimer's disease,thus helping to clarify the mechanisms underlying the condition and exploring more effective therapeutic options.展开更多
Cardiac injury initiates repair mechanisms and results in cardiac remodeling and fi-brosis,which appears to be a leading cause of cardiovascular diseases.Cardiac fi-brosis is characterized by the accumulation of extra...Cardiac injury initiates repair mechanisms and results in cardiac remodeling and fi-brosis,which appears to be a leading cause of cardiovascular diseases.Cardiac fi-brosis is characterized by the accumulation of extracellular matrix proteins,mainly collagen in the cardiac interstitium.Many experimental studies have demonstrated that fibrotic injury in the heart is reversible;therefore,it is vital to understand differ-ent molecular mechanisms that are involved in the initiation,progression,and resolu-tion of cardiac fibrosis to enable the development of antifibrotic agents.Of the many experimental models,one of the recent models that has gained renewed interest is isoproterenol(ISP)-induced cardiac fibrosis.ISP is a synthetic catecholamine,sympa-thomimetic,and nonselectiveβ-adrenergic receptor agonist.The overstimulated and sustained activation ofβ-adrenergic receptors has been reported to induce biochemi-cal and physiological alterations and ultimately result in cardiac remodeling.ISP has been used for decades to induce acute myocardial infarction.However,the use of low doses and chronic administration of ISP have been shown to induce cardiac fibrosis;this practice has increased in recent years.Intraperitoneal or subcutaneous ISP has been widely used in preclinical studies to induce cardiac remodeling manifested by fibrosis and hypertrophy.The induced oxidative stress with subsequent perturbations in cellular signaling cascades through triggering the release of free radicals is consid-ered the initiating mechanism of myocardial fibrosis.ISP is consistently used to induce fibrosis in laboratory animals and in cardiomyocytes isolated from animals.In recent years,numerous phytochemicals and synthetic molecules have been evaluated in ISP-induced cardiac fibrosis.The present review exclusively provides a comprehensive summary of the pathological biochemical,histological,and molecular mechanisms of ISP in inducing cardiac fibrosis and hypertrophy.It also summarizes the application of this experimental model in the therapeutic evaluation of natural as well as syn-thetic compounds to demonstrate their potential in mitigating myocardial fibrosis and hypertrophy.展开更多
BACKGROUND Pheochromocytoma,a rare catecholamine-secreting tumor,typically presents with the classic triad of headache,palpitations,and diaphoresis,often accompanied by cardiovascular manifestations.While vomiting occ...BACKGROUND Pheochromocytoma,a rare catecholamine-secreting tumor,typically presents with the classic triad of headache,palpitations,and diaphoresis,often accompanied by cardiovascular manifestations.While vomiting occurs in approximately 34.5%of cases,it is rarely the predominant and persistent presenting symptom.Pheochro-mocytoma-induced cardiomyopathy leading to heart failure is a recognized but uncommon complication.Due to its heterogeneous presentations,misdiagnosis and diagnostic delay are frequent.CASE SUMMARY A 53-year-old female presented predominantly with persistent and refractory vomiting as her chief complaint,accompanied by signs of acute heart failure[left ventricular ejection fraction(LVEF)30%].Initial evaluation at a primary hospital,including coronary angiography(revealing only mild stenosis),led to a misdia-gnosis of coronary artery disease.Despite standard anti-thrombotic,anti-heart failure,and anti-emetic therapy,her vomiting persisted and heart failure did not resolve.Subsequent hospitalization revealed dramatic paroxysmal hypertension(202/129 mmHg to 97/51 mmHg)and fever.Significantly elevated plasma meta-nephrines and normetanephrine,combined with abdominal computed tomogra-phy and magnetic resonance imaging,confirmed a right adrenal pheochromo-cytoma.This diagnosis was significantly delayed due to the atypical prominence of gastrointestinal symptoms masking the underlying endocrine crisis.CONCLUSION This case highlights a highly atypical presentation of pheochromocytoma domi-nated by refractory vomiting and complicated by acute catecholamine-induced cardiomyopathy.It emphatically underscores that pheochromocytoma must be considered in the differential diagnosis for patients presenting with unexplained,treatment-resistant vomiting,particularly when co-existing with acute heart failure.The presence of labile hypertension,even if not initially evident,provides a crucial diagnostic clue.Prompt biochemical screening(catecholamine metabolites)and adrenal imaging are essential to prevent diagnostic delay and enable timely,life-saving surgical intervention.展开更多
文摘The measurement of urine catecholamine and metanephrine concentrations is important for biochemical screening and diagnosis of pheochromocytoma.The goal of this work was to develop a simple liquid chromatography-tandem mass spectrometry(LC-MS/MS)method for determining catecholamines and metanephrines in urine to replace an existing liquid chromatographic method using electrochemical detection.Urine samples were prepared using Oasis weak-cation-exchange cartridges.The eluate was analyzed on an Agilent ZORBAX Eclipse Plus Phenyl-Hexyl column in 3 min.Adrenaline,noradrenaline,dopamine,metanephrine,normetanephrine,and their deuterated internal standards were monitored in positive electrospray ionization mode by multiple reaction monitoring(MRM).No evidence of ion suppression was observed.The assay was linear up to 5μmol/L for adrenaline,5μmol/L for noradrenaline,6.1μmol/L for dopamine,5.6μmol/L for metanephrine,and 34.6μmol/L for normetanephrine,with lower limits of quantification of 5,5,12,6 and 7nmol/L,respectively.The intra-day and inter-day precisions for all analytes ranged from 0.59%to 4.64%and1.98%to 4.80%,respectively.External quality assurance samples were assayed and showed excellent agreement with the target values.This simple method provides an improved assay for determining urine catecholamines and metanephrines.
基金supported by the Research Projects of Hainan Province Health Planning Industry(grant numbers:2012ZD-03)
文摘Objective:To investigate the relationship between the levels of plasma adrenaline and norepinephrine and gene polymorphism ofβ1 adrenergic receptor G1165 C in children with enterovirus 71(EV71)infection in hand foot and mouth disease(HFMD).Methods:The polymerase chain reaction(PCR)was used to detect the expression of gene polymorphism ofβ1 adrenergic receptor G1165 C in vitro.The levels of plasma adrenaline and norepinephrine were measured by enzyme-linked immunosorbent assay(ELISA).Results:The plasma norepinephrine level of severe group was significantly higher than the mild group in children with EV71 infection in HFMD(P<0.05);however,the levels of plasma adrenalinein in two groups had no statistical differences(P>0.05);There was no significant difference in the distribution ofβ1 adrenergic receptor G1165 C genotype and allele between EV71 infection group and healthy control group(P>0.05).Further analysis of EV71 infection group by dividing it into mild and severe groups showed that there was no significant difference in the distribution of genotype and allele between these two groups as well(P>0.05).There was no significant difference in the levels of epinephrine and norepinephrine in different genotypes of EV71 infection group(P>0.05),and in the levels of plasma epinephrine and norepinephrine in the mild and severe groups(P>0.05).Conclusions:As the disease gets worse,the plasma norepinephrine level has a rising trend in children with EV71 infection in HFMD,which is an important indicator to evaluate the progress of the disease.However,the gene polymorphism of eptor G1165 C have no significant correlation,not only with the susceptibility and severitβ1 adrenergic recy of EV71 infection in hand,foot and mouth disease,but also with the levels of catecholamine.
文摘Objective.To compare the effects of alfentanil and esmolol on hemodynamic and catecholamine response to tracheal intubation. Methods.Thirty five adult patients were randomly allocated to one of three groups,Group A(control group),Group B(esmolol group)and Group C(alfentanil group).The patients received either 2 mg/kg esmolol(in Group B)or 30 μg/kg alfentanil(in Group C)before intubation.Tracheal intubation was performed with 4 mg/kg thiopental and 0 1 mg/kg vecuronium and 3% isoflurane.Systolic blood pressure(SBP),diastolic blood pressure(DBP),mean blood pressure(MBP),heart rate(HR),norepinephrine(NE),epinephrine(E)and dopamine(DA)were measured before and after intubation. Results.The control group had a baseline SBP of 149±23 mmHg while Groups B,C had a baseline SBP of 148±23,and 150±21mmHg,respectively(P>0 05).Three min after tracheal intubation,the control group SBP increased to 160±30 mmHg and Group B remained at the baseline level,147±5 mmHg,and Group C significantly decreased to 91±22 mmHg(P<0 01).Two min after intubation HR in Group B increased significantly but 3 min after intubation HR in Groups B and C were significantly lower than that of control group(P<0 05).NE in Groups A and B increased significantly to 5 75±3 51 and 6 75±3 30 nmol/L 3 min after intubation(P<0 01).In Group C,3 min after intubation NE was not significantly different from the baseline but E decreased significantly(P<0 01). Conclusion.2 mg/kg esmolol can moderate the hemodynamic response to tracheal intubation to a certain extent and 30μg/kg alfentanil can completely attenuate the hemodynamic and catecholamine responses.
基金ThisprojectwassupportedbyHubeiScienceDevelopmentalFoundation (No 2 0 0 0 2P170 5 )
文摘The role of catecholamine (CA) in the pathogenesis and development of macular edema of central serous chorioretinopathy (CSC) was studied, and its relations with visual acuity were investigated Plasma concentrations of epinephrine (E) and norepinephrine (NE) were determined in 30 consecutive eyes with CSC Central macular thickness analysis was done by RTA and all the data were compared with normal eyes and analyzed with SAS software package Plasma concentrations of E and NE were increased to (569±123) ng/L and (721±104) ng/L respectively in active CSC patients, significantly higher than those in normal subjects ( P< 0 01), and decreased to normal in convalescent stage RTA analysis revealed that the retinal thickness of CSC patients was increased at active and recovery stage as compared with normal subjects; and the plasma concentration of E was significantly correlated with central macular thickness( t =2 173, P< 0 05) Also, central macular thickness measured by RTA was significantly correlated with the visual acuity ( r = -0 8046 , P< 0 001) in CSC eyes RTA analysis might be useful to quantitatively detect and evaluate prognosis in CSC patients The plasma concentration of E, which was highly correlated with macular edema, might play an important role in the early damage and the pathogenesis of CSC
基金the National Natural Science Foundation of China （No. 20575056） the 0utstanding Youth Science Foundation of Henan Province （No. 04120001300） Henan Innovation Project for University Research Talents （No. 2005126）.
文摘A rapid and sensitive method for the analysis of three catecholamines by capillary electrophoresis （CE） with direct chemiluminescence （CL） detection is described. The detection limits （S/N= 3） were 1.3 × 10^-8 g/mL for isoprenaline, 1.0 × 10^-8g/mL for epinephrine and 2.8 × 10^-8 g/mL for dopamine. The proposed method was successfully applied to the analysis of catecholamines in urine samples of cigarette smokers and nonsmokers. The results showed that there is a close relation between the release of dopamine in human body fluids and cigarette smoking/nonsmoking.
基金funded by a Medical Research Council(UK)Experimental Medicine grant[MR/M006646/1]
文摘Autosomal recessive mutations in the PARK7 gene,which encodes for the protein DJ-1,result in a loss of function and are a cause of familial Parkinson’s disease（PD）,while increased wild-type DJ-1protein levels are associated with some forms of cancer.Several functions of DJ-1 have been described,with the greatest evidence indicating that DJ-1 is a redox-sensitive protein involved in the regulation of oxidative stress and cell survival.
基金support by Chinese National Science Foundation(No.3997801)
文摘The serum thyroid hormone and plasma catecholamine were examined in 18 male and 2 female members of the Chinese Antarctic Expedition (who spent the 2000 or 2001 austral winter at the Great Wall Station) . The changes of serum thyroid hormone i. e. total thyroxine (TT4) and free T4 (FT4) , total triodothyronine (TT3) and freeT3 ( FT3 ) , thyroid stimulating hormone ( TSH ) and plasma catecholamine, including norepinephrine (NE) , epinephrine ( E) and dopamine ( DA ) , were investigated by Chemoluminescence Immunoassay (CLIA) and High Performance Liquid Chromatography with electrochemical detection (HPLC-ECD) . Samples were taken at different time; (1)1 day before departure to Antarctica (16th expedition 1999/12/ 09; 17th expedition 2000/12/06). (2) 1 day after returned to China after living 54 weeks in Antarctica ( 16th expedition 2000/12/25 ; 17th expedition 2001/12/25 ). Comparing the data of before departure and returned, results showed that there was a significant decrease in the contents of TT4 (P <0. 01) with no significant change in the content of TT3 , FT3 and FT4. It was also found that the content of TSH increased significantly (P <0. 001) ; No significant changes of plasma NE and DA were found but the content of E decreased significantly ( P < 0. 001) . The results indicated that the special Antarctic environment led to a restrain effect on the thyroid function and the level of plasma E in Antarctic expedition members. Both the thyroid and adrenal medulla system were associated in response to the Antarctic systemic stress.
基金ThisstudywassupportedbyagrantfromtheNationalScienceFoundationofChina (No .96-90 6-1 1 -0 1 )
文摘To study the effects of electroacupuncture on sympathetic adrenomedullary(SA) system and renin angiotensin aldosterone (RAA) system in open heart surgical patients undergoing cardiopulmonary bypass (CPB), 30 patients with atrial septal defect were randomly divided into general anesthesia (GA) group, acupuncture anesthesia (AA) group and acupuncture with general anesthesia (AGA) group. Peripheral blood samples were taken before anesthesia and 30 min after CPB. The plasma concentrations of norepinephrine (NE), epinphrine (E) and angiotensinⅡ(AⅡ) were detected. Results: Plasma NE and E of post CPB increased significantly in GA group and AA group, but decreased significantly in AGA group. Plasma AⅡ of post CPB increased significantly in GA group, but no marked changes were found in AA group and AGA group. Conclusions: Acupuncture can improve the AⅡ response to cardiac surgery and CPB. AGA but not AA can inhibit the catecholamine (CA) response to cardiac surgery and CPB.
基金Supported by a research foundation of Hebei Provincial Science and Technology Commitee (399413 ).
文摘Objective To investigate the stratification risk of catecholamines-β-adrenoceptor (β-AR)-cAMP pathway for cardiogenic death events in patients with congestive heart failure (CHF). Methods A total of 83 identified CHF patients with a baseline and follow-up plasma levels of norepinephrine (NE) and epinephrine (E), lymphocytes β-AR density (Bmax), and intralymphocyte cAMP content in peripheral blood were followed up. Major cardiogenic death events were registered. Results The period between the initial entry and the last follow-up measurement were 51±16 months, the total duration of clinical follow-up after the last measurement were 14±8 months. During follow-up, 39 patients died of cardiogenic (sudden death 17 patients, worsening heart failure 22 patients). Persistence of high NE, E, and cAMP from baseline to follow-up were confirmed as risk predicting factors of cardiovascular events. Persistence NE above 4.0 nmol/L, E above 3.5 nmol/L, and the intralymphocyte cAMP content above 3.5 pmd·mg-1·pro-1 from baseline to follow-up were significant adverse prognostic predictors. The major cardiogenic death events rates per 100 patients-years were 1.33 and 4.82 in patients with NE below and above 4.0 nmol/L (HR: 2.91; 95% CI: 1.08-7.33; P = 0.015); were 1.42 and 4.36 in the patients with E levels below and above 3.5 nmol/L (HR: 2.64; 95% CI: 1.02-6.41; P = 0.019); were 1.81 and 4.67 in the patients with the intralymphocyte cAMP content below and above 3.5 pmd·mg-1·pro-1 (HR: 2.79; 95% CI: 1.04-6.83; P = 0.017), but difference was not significant between the β-AR density below and above median. Conclusions Persistent increase in circulating catecholamines and intralymphocyte cAMP content may increase the long-term mortality in CHF patients.
基金supported by the National Natural Science Foundation of China(No.20775070)the Natural Science Foundation ofZhejiang Province(Nos.R4080124 and Y5100280)the Analysis and Tesfing Foundation of Zhejiang Province(No.2011C37034)
文摘A simple,fast,sensitive,highly selective and eco-friendly analytical method for the determination of catecholamines in human urine by ion chromatography（IC） with chemiluminescence（CL） detection was described in this paper.Using 12 mmol/L H_2SO_4 without any organic additive as eluent,three catecholamines including epinephrine（EP）,norepinephrine（NE） and dopamine（DA） were well separated on a cation-exchange column.The CL detection was based on the reaction of analytes with acidic potassium permanganate in the presence of formaldehyde as an enhancer.The absence of methanol and acetonitrile in eluent made the proposed method more sensitive and eco-friendly.Under the optimal conditions,the linear range of the proposed method was in the range of 0.02-0.5μg/mL.The limit of detection（LOD） was in the range of 0.6 and 5.1μg/L.The relative standard deviations （RSD） for 0.1μg/mL mixed standard solution were in the range of 0.8-1.9%（n = 11）.The method has been applied to the determination of catecholamines in human urine successfully.Excellent spiked recoveries were achieved for catecholamines ranged from 91.2%to 112.7%.
基金supported by the Fundamental Research Foundation of Xi’an Polytechnic University ( XGJ07001)
文摘Preconcentration of catecholamines by the modified monolithic silica in the capillary was investigated in this study. In order to achieve a microchip-based method for determining catecholamines in the saliva,the monolithic silica was fabricated in the capillary and the monolithic silica was chemically modified by on-column reaction with phenylboronate. Different modified methods were compared. The concentration conditions were optimized. This study indicates the applicability of the modified monolithic silica capillary when it was used to concentrate catecholamines.
文摘Manganese is an essential metal in human that functions in many enzymes. In contrast excessive exposure to Mn results in neurotoxicity. Accumulation of manganese damages central nervous system and causes Parkinson disease like syndrome called manganism. Mn neurotoxicity has been suggested to involve an imbalance in catecholamine neurotransmitters. It hypothesized that Mn can obstruct catecholamine synthesis pathway by inhibition of Tyrosine hydroxylase. Previous studies demonstrated that chronic and acute dose of Mn has different possible effects on catecholamine synthesis. It’s assumed that an acute dose of manganese can kill dopaminergic cells. Therefore, we focused the effect of Mn in catecholamine concentration on the rat’s brain by MnCl2 injection intraperitoneally and analyzed their brains after the time interval. This study used different acute doses in short time courses and different chronic doses at different exposing times to investigate which of them (exposing dose or time) is more important in Mn toxic effect. Measurement of catecholamine concentration performed by fluorescence assay in acidic and oxidant environment.
文摘The objective of this review is to summarize current data obtained so far in catecholamine-essential hypertension(EH) relationships on a genetic basis. As the major elements driving the sympathetic system's actions, catecholamines modulate a variety of physiological processes and mutations related to the system. This could generate serious disorders, such as severe mental illnesses, stress-induced disorders, or impairedcontrol of blood pressure or motor pathways. EH is idiopathic, and the genetic basis of its causes and substantial interindividual discrepancies in response to different types of treatments are the focus of interest. Susceptibility to disease or efficacy of treatments are thought to reflect genomic variabilities among individuals. Therefore, outlining the available knowledge in functional genetic polymorphisms linked to EH will make the picture clearer and will help to establish future prospects in the field.
文摘Nitric oxide (NO) regulates a wide range of physiological processes. Recent studies show that NO can regulate the release of catecholamines (CA) from the adrenal medulla. In the current study, the PC12 cell line was used to examine the effect of NO on the regulation of the CA biosynthetic enzymes: tyrosine hydroxylase (TH), dopamine-β-hydroxylase (DBH) and phenylethanolamine Nmethyltransferase (PNMT). Treatment of PC12 cells with the NO donor, sodium nitroprusside (SNP) for 6 hours significantly increased TH, DBH and PNMT mRNA levels. In addition, NO potentiates the regulation of gene expression of all three CA biosynthetic enzymes by glucocorticoids and cholinergic agonists. The signaling pathways involved in NO regulation of CA biosynthetic enzymes were investigated with the use of specific kinase activators and inhibitors, with results supporting a contributing role of PKA, PKC and PKG in SNP-mediated induction for all three CA genes (p < 0.01). In addition, inhibitors of transcription and translation inhibited SNP-mediated induction of all three genes (p < 0.001) suggesting that both transcriptional and translational mechanisms may be involved in CA gene regulation by NO. Results from this study show that in addition to regulating CA biosynthetic enzymes, NO can also potentiate cholinergic and glucocorticoid activation of CA genes.
文摘Objective: To observe changes of plasma catecholamine (CA) level in patients experiencing cholecystectomy under acupuncture anesthesia combined with epidural administration of small dose of anesthetics. Methods: 33 cholecystectomy patients were randomly divided into acupuncture combined with epidural anesthesia (A) group (n=11), acupoint skin electrical stimulation combined with epidural anesthesia (B) group (n=11) and simple epidural anesthesia (C) group (n=11). Acupoints used were bilateral Zusanli (ST 36) and Neiguan (PC 6) and stimulated with parameters of frequency 2/15 Hz, intermittent waves, electric current 2～3 mA for group A and 13mA for group B. Extradural anesthetic administered was 1.5% Lidocaine 5 mL. Venous blood samples were collected one day before, during and 3 days after operation for detecting plasma NE, E and DA contents. Results: ① During operation, plasma NE of group A and B lowered in comparison with pre operation, particularly group A (P<0.01), while in group C, plasma NE level increased slightly; plasma E of group A and B increased significantly compared with pre operation (P< 0.01). Plasma DA in the 3 groups all raised during operation. ② Three days after operation, plasma NE, E and DA levels recovered basically in comparison with those of one day before operation. It indicates that acupuncture or acupoint skin electrical stimulation is capable of regulating sympathetic activity during epidural anesthesia. The anesthetic effect has a closer relation with changes of plasma NE level rather than changes of plasma E or DA levels. Conclusion: Acupuncture or acupoint surface electrical stimulation combined with epidural anesthesia may be of reducing or releasing surgical operation generated stress response during cholecystectomy.
文摘Background:Caregivers of dementia patients have significantly higher levels of serum IL-6 and CRP compared to non-caregivers,and the accumulation of everyday stressors reportedly promotes the induction of inflammatory markers.However,few studies have identified factors that affect catecholamine levels in caregivers who experience a combination of physical and mental stress from caregiving.Purpose:This study aimed to identify physical factors that impact catecholamine levels in caregivers of dementia patients.Methods:Participants were elderly caregivers living together with elderly Alzheimer’s-type dementia patients.We performed logistic regression analysis,with levels of adrenaline,noradrenaline,and dopamine(indicators of catecholamine)as dependent variables.Results:Caregiver BMI had a significant impact on adrenaline levels(OR:0.792;95%CI:0.654-0.960)and noradrenaline levels(OR:1.210;95%CI:1.009-1.451),whereas age had a significant impact on dopamine levels(OR:1.162;95%CI:1.019-1.324).Discussion:While caregiver BMI significantly impacted adrenaline and noradrenaline levels,the mechanism underlying these relationships is unclear.One possibility is that obesity(BMI)and a rise in sympathetic nerve activity contributed to hypertension.Our findings suggest that chronic stress in elderly caregivers may potentially impair the dopaminergic activation system in the brain.Conclusion:There is a need to identify factors which increase BMI in caregivers.Future studies aimed at gaining a better understanding of the lifestyle habits of caregivers and intervention studies aimed at reducing their BMI are warranted.
文摘A flow injection chemiluminescence (CL) method for the determination of catecholamines is described which is based on their inhibition of the intensity of CL from the luminol-hypochlorite system The hypochlorite was electrogenerated on-line by a constant current electrolysis, resulting in the elimination of the instability of the hypochlorite solution prepared from a commercial reagent of sodium hypochlorite. The detection limits are 0.6 ng/ml for dopamine, 0.8 ng/ml for adrenaline and isoprenaline. The proposed method has been successfully applied to the determination of catecholamines in pharmaceutical injections.
文摘Alzheimer's disease is a common neurodegenerative disorder in older adults.Despite its prevalence,its pathogenesis remains unclea r.In addition to the most widely accepted causes,which in clude excessive amyloid-beta aggregation,tau hyperphosphorylation,and deficiency of the neurotransmitter acetylcholine,numerous studies have shown that the dopaminergic system is also closely associated with the occurrence and development of this condition.Dopamine is a crucial catecholaminergic neurotransmitter in the human body.Dopamine-associated treatments,such as drugs that target dopamine receptor D and dopamine analogs,can improve cognitive function and alleviate psychiatric symptoms as well as ameliorate other clinical manifestations.Howeve r,therapeutics targeting the dopaminergic system are associated with various adverse reactions,such as addiction and exacerbation of cognitive impairment.This review summarizes the role of the dopaminergic system in the pathology of Alzheimer's disease,focusing on currently available dopamine-based therapies for this disorder and the common side effects associated with dopamine-related drugs.The aim of this review is to provide insights into the potential connections between the dopaminergic system and Alzheimer's disease,thus helping to clarify the mechanisms underlying the condition and exploring more effective therapeutic options.
基金United Arab Emirates University,Grant/Award Number:12R104 and 12R121。
文摘Cardiac injury initiates repair mechanisms and results in cardiac remodeling and fi-brosis,which appears to be a leading cause of cardiovascular diseases.Cardiac fi-brosis is characterized by the accumulation of extracellular matrix proteins,mainly collagen in the cardiac interstitium.Many experimental studies have demonstrated that fibrotic injury in the heart is reversible;therefore,it is vital to understand differ-ent molecular mechanisms that are involved in the initiation,progression,and resolu-tion of cardiac fibrosis to enable the development of antifibrotic agents.Of the many experimental models,one of the recent models that has gained renewed interest is isoproterenol(ISP)-induced cardiac fibrosis.ISP is a synthetic catecholamine,sympa-thomimetic,and nonselectiveβ-adrenergic receptor agonist.The overstimulated and sustained activation ofβ-adrenergic receptors has been reported to induce biochemi-cal and physiological alterations and ultimately result in cardiac remodeling.ISP has been used for decades to induce acute myocardial infarction.However,the use of low doses and chronic administration of ISP have been shown to induce cardiac fibrosis;this practice has increased in recent years.Intraperitoneal or subcutaneous ISP has been widely used in preclinical studies to induce cardiac remodeling manifested by fibrosis and hypertrophy.The induced oxidative stress with subsequent perturbations in cellular signaling cascades through triggering the release of free radicals is consid-ered the initiating mechanism of myocardial fibrosis.ISP is consistently used to induce fibrosis in laboratory animals and in cardiomyocytes isolated from animals.In recent years,numerous phytochemicals and synthetic molecules have been evaluated in ISP-induced cardiac fibrosis.The present review exclusively provides a comprehensive summary of the pathological biochemical,histological,and molecular mechanisms of ISP in inducing cardiac fibrosis and hypertrophy.It also summarizes the application of this experimental model in the therapeutic evaluation of natural as well as syn-thetic compounds to demonstrate their potential in mitigating myocardial fibrosis and hypertrophy.
基金Supported by National Natural Science Foundation of China,No.82200353Jiangsu Province Double Innovation Doctoral Program,No.JSSCBS20221948+4 种基金Suzhou Gusu Health Talent Program,No.(2022)043Suzhou Gusu Health Talent Plan Talent Research Project,No.GSWS2022014Suzhou Science and Technology Innovation Policy Funding Projectthe Jiangsu Province College Students’Innovation and Entrepreneurship Training Program Project,No.202410285087Z“Bo Xi”Talent Casting Plan of the First Affiliated Hospital of Soochow University.
文摘BACKGROUND Pheochromocytoma,a rare catecholamine-secreting tumor,typically presents with the classic triad of headache,palpitations,and diaphoresis,often accompanied by cardiovascular manifestations.While vomiting occurs in approximately 34.5%of cases,it is rarely the predominant and persistent presenting symptom.Pheochro-mocytoma-induced cardiomyopathy leading to heart failure is a recognized but uncommon complication.Due to its heterogeneous presentations,misdiagnosis and diagnostic delay are frequent.CASE SUMMARY A 53-year-old female presented predominantly with persistent and refractory vomiting as her chief complaint,accompanied by signs of acute heart failure[left ventricular ejection fraction(LVEF)30%].Initial evaluation at a primary hospital,including coronary angiography(revealing only mild stenosis),led to a misdia-gnosis of coronary artery disease.Despite standard anti-thrombotic,anti-heart failure,and anti-emetic therapy,her vomiting persisted and heart failure did not resolve.Subsequent hospitalization revealed dramatic paroxysmal hypertension(202/129 mmHg to 97/51 mmHg)and fever.Significantly elevated plasma meta-nephrines and normetanephrine,combined with abdominal computed tomogra-phy and magnetic resonance imaging,confirmed a right adrenal pheochromo-cytoma.This diagnosis was significantly delayed due to the atypical prominence of gastrointestinal symptoms masking the underlying endocrine crisis.CONCLUSION This case highlights a highly atypical presentation of pheochromocytoma domi-nated by refractory vomiting and complicated by acute catecholamine-induced cardiomyopathy.It emphatically underscores that pheochromocytoma must be considered in the differential diagnosis for patients presenting with unexplained,treatment-resistant vomiting,particularly when co-existing with acute heart failure.The presence of labile hypertension,even if not initially evident,provides a crucial diagnostic clue.Prompt biochemical screening(catecholamine metabolites)and adrenal imaging are essential to prevent diagnostic delay and enable timely,life-saving surgical intervention.
