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Fever in Pheochromocytoma
Donald L. Gordon, MD;
Susan D. Atamian, MD;
Marion H. Brooks, MD;
Paolo Gattuso, MD;
Melanie J. Castelli, MD;
Jonas Valaitis, MD;
William Thomas, Jr, MD
Arch Intern Med. 1992;152(6):1269-1272.
Abstract
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Background.—
Fever is an infrequently reported finding in patients with pheochromocytoma. Fever in patients with pheochromocytoma may be caused by the tumor, an infection or other factors, each of which will dictate different treatment strategies.
Methods.—
To determine the incidence, cause, and significance of fever in patients with pheochromocytoma, we reviewed the medical records of 50 hospitalizations of 48 patients. Patients were categorized by the presence or absence of fever. Body temperature elevation, duration of hospitalization in the period prior to surgery or death, age, sex, race, other conditions that could have been responsible for the febrile episode (comorbid events), location, gross and microscopic features of the tumors, and plasma and urine hormone levels were tabulated. The results were compared between the two groups of patients.
Results.—
Fever was present in 14 (28%) of 50 hospitalizations, seven patients (50%) of whom had pheochromocytoma multisystem crisis. Patients with fever and pheochromocytoma were significantly more likely to have a comorbid event, larger tumor, necrosis within the tumor, higher urinary metanephrine levels, longer duration of hospitalization prior to surgery, and to be non-white. Comorbid events included both infectious and noninfectious potential causes of fever.
Conclusions.—
Fever is common in patients with pheochromocytoma. The causes may be multifactorial and often include an associated illness. A thorough search for coexisting disease is indicated. While fever may prolong hospitalization, it does not portend a disastrous outcome.
(Arch Intern Med. 1992;152:1269-1272)
Author Affiliations
From the Section of Endocrinology and Metabolism, Department of Medicine (Drs Gordon, Atamian, and Brooks), Section of Cytopathology, Department of Pathology (Drs Gattuso and Castelli), Loyola University of Chicago, Maywood, Ill; Department of Pathology, Lutheran General Hospital, Park Ridge, Ill (Dr Valaitis); and Department of Pathology, Mount Sinai Hospital Medical Center, Chicago, Ill (Dr Thomas).
Footnotes
Accepted for publication January 17, 1992.
Reprint requests to the Section of Endocrinology and Metabolism, Loyola University Medical Center, 2160 S First Ave, Maywood, IL 60153 (Dr Gordon).
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