ABSTRACT
Pseudopheochromocytoma is a pathological condition presenting with paroxysmal hypertension with normal or moderate elevation in catecholamines and metanephrine levels, but no evidence of a tumoural cause. Imaging studies and I-123 metaiodobenzylguanidine scintigraphy are essential for exclusion of pheocromocytoma. We describe a case of pseudopheochromocytoma related to levodopa in a patient with paroxysmal hypertension, headache, sweating, palpitations and increased plasmatic and urinary metanephrine levels, without adrenal or extra-adrenal tumour. The beginning of the patient's clinical symptoms coincided with the initiation of the levodopa treatment and the complete resolution of the symptoms occurred after the discontinuation of levodopa. LEARNING POINTS: Pseudopheochromocytoma and pheochromocytoma may have the same clinical and laboratorial presentation but different aetiologies.The diagnosis of pseudopheochromocytoma is based on paroxysmal hypertension with normal or increased plasma and urine levels of catecholamines or metanephrines after exclusion of a tumoural process.The pseudopheochromocytoma may be associated with levodopa, alone or in combination with other drugs that are likely to interfere with dopamine or catecholamine metabolism.
ABSTRACT
Background: Anemia and thrombocytopenia are common features in patients with Systemic Lupus Erythematosus (SLE). However, erythroid aplasia and amegakaryocytosis as the main physiopathological causes without other associated disorders have been rarely described. Case report: We report a 29 y/o female with SLE presenting with severe anemia and thrombocytopenia due to a bone marrow immunological blockage. The patient, who initially refused transfusions, was successfully treated and had a very fast hematological response to steroids, immunoglobulin, plasma exchange, eltrombopag, and rituximab. Discussion: This is an unusual case and it is possible that in this kind of patients plasma exchange associated with immunosuppressant therapy may lead to a faster, more effective, and sustained recovery of the hematological disorders. (AU)
