İzole Abducens Paralizisi ve Akut Koroner Sendrom ile prezente olan Paraganglioma olgusu

Abstract

Paragangliomalar, adrenal bez dışındaki otonomik sinir sisteminin ganglion zincir kromaffin hücrelerinden köken alırlar ve katekolamin salgılayan tümörlerin %10-15'ini oluştururlar. Yetişkinlerde en sık dördüncü ve beşinci dekadda gözlenirler. Klinikte hipertansiyon, çarpıntı ve terleme ataklarının eşlik ettiği baş ağrısına vurgu yapılmaktadır. Bununla birlikte, hastaların %5-15'i normotensif olup ortostatik hipotansiyon atakları dahi yaşayabilir. Kardiyovasküler komplikasyonlar arasında miyokardit, kardiyomiyopati, atriyal veya ventriküler aritmiler, akut koroner sendrom bulunmaktadır. Özellikle hipovolemi varlığında vasküler ton kaybı eklenmesiyle birlikte şok tablosu gözlenebilir. Nörolojik bulgular olarak ise mental durum değişiklikleri, hipertansif ensefalopati ve inme sıralanabilir. Bu makalemizde iç hastalıkları polikliniğine başvurusu sonrası paraganglioma tanısı konulan hasta sunulmaya çalışılmıştır.

Keywords

• Paraganglioma,Akut koroner sendrom,İzole Abducens paralizisi

A case of paraganglioma presenting with isolated Abducens Paralysis and Acute Coronary Syndrome

Abstract

Paragangliomas originate from ganglion chain chromaffin cells of the autonomic nervous system other than the adrenal gland and constitute 10-15% of catecholamine-secreting tumors. They are most frequently observed in the fourth and fifth decade in adults. In the clinic, headache associated with hypertension, palpitation and sweating attacks is emphasized. However, 5-15% of patients are normotensive and may experience orthostatic hypotension attacks. Cardiovascular complications include myocarditis, cardiomyopathy, atrial or ventricular arrhythmias, and acute coronary syndrome. Shocks may be observed with the addition of vascular tone loss especially in the presence of hypovolemia. As neurological findings mental status changes, hypertensive encephalopathy and stroke can be listed. In this article, we present a patient who was diagnosed with paraganglioma after admission to the internal medicine outpatient clinic.

Keywords

• Paraganglioma,Acute coronary syndrome,Abducens paralysis

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