ESPE Abstracts

Intoduction: Pheochromocytoma is a neuroendocrine disease rarely encountered in childhood, and it’s complications are even less frequent among children. Catecholamine-induced cardiomyopathy (CICMPs) is a rare complication of pheochromocytoma with a reported incidence of 8–11 % of all patients. Symptoms are often accompanied by hypertension, which is most common among children. However, classical symptoms such as hypertension, paroxysmal headache, sweating, palpitation do not necessarily occur in all patients with CICMPs. In absence of clear signs of catecholamine excess, patients with non-ischemic and non-valvular cardiomyopathy should be considered as possible cases of CICMP.

Case Presentation: 14-year-old girl was admitted to the pediatric cardiology department with complaints of severe shortness of breath, excessive sweating, fatigue and weakness. According to outpatient records, EchoCG revealed a marked decrease in the contractility of the left ventricular myocardium with an ejection fraction of 17-19%. Initial observation and tests were consistent with diagnosis of dilated cardiomyopathy and heart failure NYHA Class 3:

Consequently, patient was consulted by endocrinologist. Secondary survey:

Therefore, patient was diagnosed with pheochromocytoma, catecholamine-induced cardiomyopathy, heart failure NYHA Class 3. Subsequently, laparoscopic tumoradrenalectomy was performed. Patient was later transferred back to pediatric cardiology department, for further heart failure and DCM treatment. Tertiary survey:

Discussion: This case shows necessity of alertness for early detection of pheochoromocytoma and it’s complications in children. Considering, the size of the tumor, and hyperplasia of the left adrenal gland, genetic study for MEN2 is necessary.