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Pheochromocytoma presenting with headache, panic attacks and jaundice in a child
1Department of Surgery, Firat University School of Medicine, Elaziğ, Turkey.
Insights
Pheochromocytoma in children can present with psychiatric symptoms like depression and panic disorder, mimicking other illnesses. Tumor removal resolved these symptoms, highlighting its importance in pediatric differential diagnosis.
Area of Science:
- Pediatric Endocrinology
- Neuropsychiatry
- Oncology
Background:
- Pheochromocytomas are rare neuroendocrine tumors, often presenting with diverse symptoms that can mimic other conditions.
- Neuropsychiatric manifestations of pheochromocytoma are increasingly recognized, primarily in adult populations.
- Pediatric cases of pheochromocytoma with psychiatric symptoms are exceptionally rare, necessitating further investigation.
Observation:
- A unique case of a child with pheochromocytoma presenting with both depression and panic disorder is detailed.
- The patient experienced persistent depression with constricting headaches and acute panic disorder with migraine-type headaches.
- Jaundice was also observed, potentially linked to catecholamine effects on hepatocytes.
Findings:
- Psychiatric symptoms, including depression and panic disorder, were directly associated with the pheochromocytoma.
- Symptomatic resolution occurred post-surgical removal of the tumor, confirming the causal link.
- The case suggests a potential adverse effect of catecholamines on liver function, leading to jaundice.
Implications:
- Pheochromocytoma should be considered in the differential diagnosis of pediatric neuropsychiatric disorders.
- Early recognition and diagnosis of pediatric pheochromocytoma can prevent severe clinical complications.
- This case underscores the importance of a comprehensive diagnostic approach in children with unexplained psychiatric and physical symptoms.
Abstract:
Pheochromocytomas can mimic many unrelated diseases due to their various presenting signs; they are encountered very rarely in childhood. Recently, their neuropsychiatric aspects have become a subject of interest for many workers, but most of the findings reported previously have been observed in adults. We present a case report which is unique in that it concerns a child with pheochromocytoma and psychiatric findings consisting of depression and panic disorder, which were interpreted as being directly related to, since they disappeared after the removal of, the tumor. Depression was persistent and accompanied by a constricting-type headache, while panic disorder was acute and accompanied by a migraine-type headache. Another intriguing complication encountered in our case was jaundice; we considered that it could possibly have been due to an adverse effect of catecholamines on hepatocyte function. We conclude that a pheochromocytoma can be confused with neuropsychiatric disorders in children as well as in adults and that it should be considered in the differential diagnosis of such disorders.