Dangerous Pitfall: Peripartum Pheochromocytoma Mimicking Severe Preeclampsia

Hypertension is a common peripartum problem. Preeclampsia is defined as hypertension that develops 20 weeks after gestation in association with proteinuria or pitting edema. Most physicians control hypertension under the provisional diagnosis of preeclampsia without further investigation. Although uncommon, pheochromocytoma misdiagnosed as preeclampsia may put both the mother and fetus in danger and, if not identified early and treated promptly, lead to a disastrous outcome. Herein, we report a 35-year-old, gravida 2. para I woman with an unremarkable medical history who presented with hypertension after 20 weeks of gestation. We diagnosed her condition as preeclampsia: but when the hypertension persisted after delivery, the diagnosis was changed to pheochromocytoma and confirmed by a series of examinations. Fortunately, both the mother and baby are healthy and without complications. Nevertheless we made an incorrect diagnosis, which could have had serious consequences. A high index of clinical suspicion must he kept and all those at risk must be investigated to achieve an early diagnosis of pheochromocytoma in pregnancy and improved maternal and fetal outcomes.