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Malignant catatonia mimicking pheochromocytoma.
Sophia Wong1, Barbara Hughes, Morris Pudek
1Department of Pathology and Laboratory Medicine, University of British Columbia, 855 West 12th Avenue, Vancouver, BC, Canada V5Z 1M9.
Case Reports in Endocrinology
|November 20, 2013
Summary
Malignant catatonia can mimic pheochromocytoma with elevated catecholamines. Prompt diagnosis and electroconvulsive therapy resolved symptoms and normalized levels in a young male patient.
Area of Science:
- Neuroscience
- Endocrinology
- Psychiatry
Background:
- Malignant catatonia presents with neuropsychiatric and autonomic symptoms.
- Clinical and biochemical findings can resemble pheochromocytoma.
- Accurate differentiation is critical due to divergent treatment strategies.
Purpose of the Study:
- To report a case of malignant catatonia mimicking pheochromocytoma.
- To highlight the importance of considering malignant catatonia in hypercatecholamine states.
Main Methods:
- Case report of a 20-year-old male with psychotic symptoms and autonomic instability.
- Biochemical analysis of 24-hour urinary catecholamines (norepinephrine, epinephrine, dopamine).
- Treatment with electroconvulsive therapy (ECT).
Main Results:
- The patient exhibited markedly elevated urinary norepinephrine, epinephrine, and dopamine levels.
- Following ECT, complete clinical resolution was achieved.
- Catecholamine and metanephrine levels normalized within weeks of treatment.
Conclusions:
- Malignant catatonia should be included in the differential diagnosis of hypercatecholamine states.
- This condition can present with biochemical profiles similar to pheochromocytoma.
- ECT is an effective treatment for malignant catatonia.
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