RESUMO
The aim of this case study is to emphasize the importance of alpha-blockade in managing a rare complication of an untreated pheochromocytoma. Clinical Presentation and Intervention: A 41-year-old man with previous bilateral pheochromocytoma presented with chest pain. He was suffering from cardiac failure and persistent hypotension requiring an inotrope. Cardiac markers, an electrocardiogram and an echocardiogram confirmed acute myocardial infarct with poor ejection fraction and global hypokinesia. An [18]F-fluorodeoxyglucose PET/CT scan showed progressive left suprarenal and organ of Zuckerkandl pheochromocytomas. Blood pressure stabilisation proved challenging but was achieved by titrating an incremental dose of alpha-blocker against a tapering inotropic dose. This case showed the efficacy of an alpha-blocker despite persistent hypotension in a patient with pheochromocytoma-induced cardiomyopathy
RESUMO
Agranulocytosis is the most serious and potentially fatal side-efiect of antithyroid drug therapy. We report two cases presenting with carbimazole-induced agranulocyotsis. The first patient received 20 mg of carbimazole daily, and developed agranulocytosis within one month of commencementoftherapy. The second patientpresented with agranulocytosis complicated by a thyroid storm following Ingestion 60 mg of carbimazole, daily for two months. Both patients were treated with 300 mg of granulocyte colony factor [GCSF] subcutaneously [in addition to discontinuation of their anti-thyroid drugs] and broadspectrum antibiotics for neutropenic sepsis. The total white and neutrophil counts returned to baseline following five and six days of treatment, respectively, with the resolution the use of GCSF in the treatment will be being discussed