Abstract
A 21-year-old woman was admitted to our hospital with a history of fever, fatigue, headache, palpitations and nausea lasting for one month. On a physical examination, her vital signs were as follows: T=38.5 °C, P=106/minute and BP=186/133 mmHg. Laboratory data revealed diabetes, with a random glucose level of 256 mg/dl and HbA1c level of 8.2 %, as well as both elevated C-reactive protein (40.21 mg/dl) and interleukin-6 (100 pg/ml) levels. In addition, computed tomography of the abdomen indicated a left adrenal tumor, while 123I-MIBG scintigraphy demonstrated accumulation of the isotope in the same region. Based on the patient's clinical data and elevated catecholamine levels, a diagnosis of pheochromocytoma was made. Consequently, almost immediate resolution of the fever followed by gradual normalization of the levels of clinical inflammatory markers was achieved after seven weeks of treatment with naproxen, doxazosin and propranolol. Furthermore, the C-reactive protein and interleukin-6 levels decreased to 0.15 mg/dl and 1.7 pg/ml, respectively, after increasing the dose of naproxen up to 600 mg, and the patient's glucose tolerance improved, enabling her to successfully stop insulin treatment prior to surgery. Therapy with naproxen for interleukin-6-producing pheochromocytoma is effective for improving secondary diabetes mellitus and may subsequently lead to reductions in the rates of perioperative complications associated with glucose intolerance.
