Lucinda M Gruber1, William F Young1, Irina Bancos2. 1. Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA. 2. Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA. Bancos.Irina@mayo.edu.
Abstract
PURPOSE OF REVIEW: Pheochromocytoma and paraganglioma (PPGL) in pregnancy is a rare entity and management of these patients is fraught with uncertainty. Our objective is to review current literature and discuss diagnosis and management of these patients. RECENT FINDINGS: Outcomes of PPGL in pregnancy have improved in recent years. The greatest risk for adverse maternal and fetal outcomes is the diagnosis of PPGL after delivery. Alpha- and beta-adrenergic blockade is well tolerated and is associated with less adverse outcomes. Antepartum surgery is not associated with improved maternal or fetal outcomes. Biochemical testing and cross-sectional imaging should be performed prior to conception for patients with a known germline variant associated with PPGL. CONCLUSIONS: Medical therapy should be initiated when PPGL is diagnosed in pregnancy. Antepartum surgery should be reserved for special circumstances. Case detection testing in high-risk patients can identify PPGL before pregnancy.
PURPOSE OF REVIEW: Pheochromocytoma and paraganglioma (PPGL) in pregnancy is a rare entity and management of these patients is fraught with uncertainty. Our objective is to review current literature and discuss diagnosis and management of these patients. RECENT FINDINGS: Outcomes of PPGL in pregnancy have improved in recent years. The greatest risk for adverse maternal and fetal outcomes is the diagnosis of PPGL after delivery. Alpha- and beta-adrenergic blockade is well tolerated and is associated with less adverse outcomes. Antepartum surgery is not associated with improved maternal or fetal outcomes. Biochemical testing and cross-sectional imaging should be performed prior to conception for patients with a known germline variant associated with PPGL. CONCLUSIONS: Medical therapy should be initiated when PPGL is diagnosed in pregnancy. Antepartum surgery should be reserved for special circumstances. Case detection testing in high-risk patients can identify PPGL before pregnancy.
Authors: Lucinda M Gruber; Robert P Hartman; Geoffrey B Thompson; Travis J McKenzie; Melanie L Lyden; Benzon M Dy; William F Young; Irina Bancos Journal: J Clin Endocrinol Metab Date: 2019-05-01 Impact factor: 5.958
Authors: Nor Azlin Mohamed Ismail; Rahana Abd Rahman; Norasyikin Abd Wahab; Rohaizak Muhammad; Kamaruddin Nor Azmi Journal: Malays J Med Sci Date: 2012-01
Authors: F Aftiss; S El Mezzeoui; G El Aidouni; M Merbouh; S Nasri; R Jabi; H Bkiyar; I Skikar; M Bouziane; B Housni Journal: Ann Med Surg (Lond) Date: 2021-11-22