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Response

Zaki Hassan-Smith, Sarah Faloon, Neil Gittoes and John Ayuk
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DOI: https://doi.org/10.7861/clinmedicine.19-1-92
Clin Med January 2019
Zaki Hassan-Smith
Queen Elizabeth Hospital Birmingham, Birmingham, UK
Coventry University, Coventry, UK
Roles: Consultant endocrinologist, Visiting professor
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Sarah Faloon
Queen Elizabeth Hospital Birmingham, Birmingham, UK
Roles: Foundation year doctor
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Neil Gittoes
Queen Elizabeth Hospital Birmingham, Birmingham, UK
Roles: Consultant and professor of endocrinology
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John Ayuk
Queen Elizabeth Hospital Birmingham, Birmingham, UK
Roles: Consultant endocrinologist
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We thank O’Toole, Brown and Drake for their informative response to our article.1 We agree that it is important to highlight alternative parenteral regimens to alpha-blockers. In addition, volume expansion and careful management of fluid status is central to successful management as in our case. We also thank Whitelaw, Prague and Mustafa for their insights into the use of mechanical circulatory support as rescue therapy. We acknowledge the association with myocardial dysfunction associated with catecholamine toxicity. In collaboration with colleagues in Oxford and London, we previously reported on the high prevalence of cardiac involvement in newly diagnosed phaeochromocytomas along with persistence of some parameters on cardiac magnetic resonance following successful surgery. We would advocate for the use of multi-centre registries for such rare conditions to improve treatment outcomes.

  • © Royal College of Physicians 2019. All rights reserved.

References

  1. ↵
    1. Faloon S
    , Venkataraman H, Skordilis K, et al. Lesson of the month 2: Blunt abdominal trauma: atypical presentation of phaeochromocytoma. Clin Med 2018;18:345–7.
    OpenUrlAbstract/FREE Full Text
    1. Ferreira VM
    , Marcelino M, Piechnik SK, et al. Pheochromocytoma is characterised by catecholamine-mediated myocarditis, focal and diffuse myocardial fibrosis, and myocardial dysfunction. J Am Coll Cardiol 2016;67:2364–74.
    OpenUrlFREE Full Text
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Response
Zaki Hassan-Smith, Sarah Faloon, Neil Gittoes, John Ayuk
Clinical Medicine Jan 2019, 19 (1) 92; DOI: 10.7861/clinmedicine.19-1-92

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Response
Zaki Hassan-Smith, Sarah Faloon, Neil Gittoes, John Ayuk
Clinical Medicine Jan 2019, 19 (1) 92; DOI: 10.7861/clinmedicine.19-1-92
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