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{
    "pk": 1166,
    "title": "Diagnosing Pheochromocytoma in the  COVID-19 Era: A Case Report",
    "subtitle": null,
    "abstract": "Introduction:\n Pheochromocytomas and paragangliomas are rare neuroendocrine tumors that secrete catecholamines. Symptoms of these tumors are related directly to catecholamine excess but can be intermittent and easily misattributed to other, more common pathologies. Identification in the emergency department (ED) is inherently difficult. During the coronavirus 2019 (COVID-19) pandemic, physicians have had to account for both the disease itself as well as associated increased prevalence of cardiac, pulmonary, and vascular complications.  Such shifting of disease prevalence arguably makes rarer diseases like pheochromocytoma less likely to be recognized.\nCase Report:\n We report a case of pheochromocytoma in a patient who presented to the ED in the fall of 2020, at a regional height of the COVID-19 pandemic, with complaints of fatigue, tachycardia, and diaphoresis. The differential diagnosis included pulmonary embolism, cardiomyopathy, congestive heart failure, and infectious causes. A broad workup was begun that included serology, electrocardiogram, computed tomography angiogram (CTA), and COVID-19 testing. Imaging was consistent with COVID-19 infection, and laboratory testing confirmed the diagnosis. A tiny retroperitoneal tumor was reported on CTA as “incidental” in the setting of multifocal pneumonia from severe acute respiratory syndrome coronavirus 2 infection. Additional history-taking revealed many years of intermittent symptoms suggesting that the tumor may have been more contributory to the patient’s presentation than originally suspected. Subsequent magnetic resonance imaging and surgical pathology confirmed the dual diagnosis of pheochromocytoma and COVID-19 pneumonia.\nConclusion:\n This case presentation highlights the importance of careful history-taking, keeping a broad differential, and examining incidental findings in the context of the patient’s presentation.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "case report"
        },
        {
            "word": "pheochromocytoma"
        },
        {
            "word": "COVID-19"
        },
        {
            "word": "cardiomyopathy"
        },
        {
            "word": "paraganglioma"
        }
    ],
    "section": "Case Reports",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/7hs5125x",
    "frozenauthors": [
        {
            "first_name": "Frank",
            "middle_name": "",
            "last_name": "Mayer III",
            "name_suffix": "",
            "institution": "Christiana Care Health System, Department of Emergency Medicine, Newark, Delaware",
            "department": "None"
        },
        {
            "first_name": "Raafia",
            "middle_name": "",
            "last_name": "Memon",
            "name_suffix": "",
            "institution": "Christiana Care Health System, Department of Endocrinology, Newark, Delaware",
            "department": "None"
        },
        {
            "first_name": "Justin",
            "middle_name": "",
            "last_name": "Stowens",
            "name_suffix": "",
            "institution": "Christiana Care Health System, Department of Emergency Medicine, Newark, Delaware",
            "department": "None"
        }
    ],
    "date_submitted": "2022-07-26T23:06:25Z",
    "date_accepted": "2022-07-26T23:06:25Z",
    "date_published": "2022-07-26T23:08:29Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "",
            "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1166/galley/906/download/"
        }
    ]
}