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The most common symptoms of pheochromocytoma are paroxysmal or sustained hypertension, or symptoms of paroxysmal adren-ergic stimulation such as palpitation, headache, and diaphoresis. These patients can on rare occasion reveal or be complicated with cardiovascular symptoms such as arrhythmia, cardiomyopathy, acute coronary syndrome and cardiogenic shock. These cardiac manifestations of pheochromocytoma may delay the diagnosis, which can cause a catastrophic outcome. A pheochromocytoma cri-sis is provoked by surgery, anesthesia, exercise and, several drugs and it is known to be an endocrine emergency with mortality as high as 85%. Many classes of drugs are well known to precipitate adverse reactions, but the presentation of pheochromocytoma af-ter the administration of steroid has rarely been reported. We report here on a case of pheochromocytoma crisis with acute myocar-dial infarction after the patient took prednisolone. Furthermore, we discuss the mechanism of glucocorticoid induced crisis and myocardial infarction in pheochromocytoma patients. (

Multiple endocrine neoplasia type 2A (MEN 2A) is an autosomal dominant syndrome characterized by the presence of medullary thyroid carcinoma, pheochromocytoma, and hyperparathyroidism. MEN 2A arises due to a germline missense mutation of the RET proto-oncogene. Specific RET mutation analysis has revolutionized the diagnosis and therapy of this disorder, and early thyroidectomy may have lowered the morbidity and mortality associated with these diseases. Ectopic adrenocorticotropic hormone (ACTH) syndrome is characterized by hypercortisolism due to the hypersecretion of ACTH outside of the pituitary gland; the most common causes are malignancies, but rarely adrenal pheochromocytoma may be the cause. We describe here a case of ectopic ACTH syndrome with bilateral pheochromocytoma in a 29-year-old man with MEN 2A presenting with medullary thyroid carcinoma and hyperparathyroidism. MEN 2A was confirmed by the detection of the RET proto-oncogene mutation. The laboratory results were compatible with ectopic ACTH syndrome. Immunohistochemical studies of the pheochromocytoma tissue confirmed the etiology of the ACTH secretion. This is the first confirmed case of the ectopic ACTH syndrome with bilateral pheochromocytoma in a Korean patient with MEN 2A. (J Korean Endocr Soc 24:265~271, 2009)

Fulminant type 1 diabetes is characterized by diabetes with an abrupt onset, severe metabolic acidosis at diagnosis, a low HbA1c level and negativity for islet cell-related autoantibodies, and this illness has been classified as type 1B diabetes by the WHO. The prevalence of this disease is higher in Japan than any other country and recently, there have been an increasing number of such case reports in Korea. Genetic factors and environmental factors such as virus infection and an immune mechanism have been suggested as the mechanism of the pathophysiology, but this remains to be clarified. We report here on a case of fulminant type 1 diabetes with ischemic ileitis in a 44 year-old male, and we include a review of the relevant literature. (J Korean Endocr Soc 24:116~120, 2009) ꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏ

Background: A number of recent clinical studies have reported marked target organ damages in patients with primary aldosteronism. The aim of this study was to compare the incidence of target organ damages in patients with primary aldosteronism (PA) and essential hypertension (EHT). Methods: The clinical records of 41 PA patients, over a 20-year period, were retrospectively analyzed. The clinical characteristics and incidence of target organ damages of 33 of the patients in this group were compared with those of 66 patients with essential hypertension, directly matched for age, gender and mean blood pressure. 8 of the PA patients could not be matched with EHT patients for age, gender and mean blood pressure, so were excluded from the comparison. The patients with essential hypertension were sampled from patients who visited for the evaluation of hypertension. Results: Ischemic heart diseases were found in 18.2 and 10.6% of patients with PA and EHT, respectively (P = 0.22). From echocardiograms, left ventricular hypertrophy was found in 93.3% and 61.4% of patients with PA and EHT, respectively (P = 0.017). The degrees of left ventricular hypertrophy were correlated with the levels of serum aldosterone, with an r value of 0.490 (P < 0.005). Cerebrovascular attack was found in 18.2% and 1.5% of patients with PA and EHT, respectively (P = 0.005). Hypertensive retinopathy was found in 50% and 33.3% of patients with PA and EHT (P = 0.255), and nephropathy was found in 42.4% and 25.8% of patients with PA and EHT, respectively (P = 0.074). Conclusion: Patients with primary aldosteronism had target organ damages more frequently than with those with essential hypertension, which was independent of blood pressure. (J Kor Endocrinol Soc 22:11~18, 2007)

Graves’ disease is an autoimmune disorder in which thyrotropin-stimulating hormone receptor antibodies stimulate the thyroid gland. Stress hormones such as catecholamine are known to play important roles in the pathogenesis of Graves’ disease. Pheochromocytoma with Graves’ disease is extremely rare, and no case has been reported within the Republic of Korea. However, according to previous studies conducted abroad, pheochromocytoma influences the pathogenesis of Graves’ disease by producing excessive cathecholamine. In the present report, we describe a 65-year-old female patient with paroxysmal hypertension and rapidly progressive body weight loss who was diagnosed as having Graves’disease with pheochromocytoma. (J Kor Endocr Soc 22:465~469, 2007)