Pheochromocytoma Presenting as Systemic Inflammatory Response Syndrome and Lactic Acidosis

Pheochromocytomas can secrete catecholamines, hormones, and cytokines, and the patterns of secretion strongly influence the complexity of the clinical presentation. We now report a patient who presented with abdominal pain, fever, leukocytosis, and tachycardia. In addition, he had lactic acidosis without shock. Our review of the literature indicates that this patient had systemic inflammatory response syndrome most likely secondary to high levels of IL-6 and that he had type B lactic acidosis secondary to high circulating levels of epinephrine. The combined presentation is unique and resolved with successful surgery. Pheochromocytoma should be included in the differential diagnosis of SIRS and of lactic acidosis.