[Hypotension and shock in pheochromocytoma]. / Hypotension und Schock beim Phäochromozytom.

A 22-year-old woman was admitted to hospital in shock, the admission diagnosis being lobar pneumonia with septic shock. Ultrasound demonstrated a tumour in the region of the left adrenal, but because of the absence of hypertensive symptoms and hypoglycaemia this was interpreted as a non-contributory finding. Despite intensive therapeutic measures the patient died within a few hours. At autopsy a phaeochromocytoma of the left adrenal gland was found. "Catecholamine myocarditis" resulting in acute cardiac failure, was demonstrated histologically. Phaeochromocytoma with predominant adrenaline or dopamine secretions often takes a normotensive or hypotensive course. Sudden excessive catecholamine release can, as in the described case, cause so-called adrenaline shock. The catecholamine-induced hypoxic-toxic myocardial changes determine the likely outcome.

Species differences in insulin secretory responses during hemorrhagic shock.

Insulin secretory rates (ISR) during intravenous glucose tolerance tests (IVGTT's) were measured in six dogs subjected to hemorrhagic shock and were compared to ISR's from five monkeys subjected to shock of comparable severity. ISR's also were measured in normotensive control dogs and monkeys subjected to the same blood sampling protocol. A sixfold increase in ISR occurred in shocked dogs after glucose loading; however, no ISR response occurred in monkeys subjected to hemorrhage. It is concluded that marked species differences exist in the insulin-glucose metabolic responses to shock. In addition, the dog would appear to be an inappropriate experimental animal as applied to trauma-insulin metabolism in man.