Pheochromocytoma: Difference between revisions
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* Pheochromocytoma is a rare tumor arising from chromaffin cells in adrenal medulla or other paraganglia in the body. | * Pheochromocytoma is a rare tumor arising from chromaffin cells in adrenal medulla or other paraganglia in the body. | ||
* Pheochromocytomas cause increased catecholamine production leading to its clinical manifestations. | * Pheochromocytomas cause increased catecholamine production leading to its clinical manifestations. | ||
==Clinical Features== | ==Clinical Features== | ||
* headache | * headache | ||
Revision as of 16:03, 11 January 2016
Background
- Pheochromocytoma is a rare tumor arising from chromaffin cells in adrenal medulla or other paraganglia in the body.
- Pheochromocytomas cause increased catecholamine production leading to its clinical manifestations.
Clinical Features
- headache
- alternating periods of normal and elevated blood pressure. Can cause resistant hypertension and hypertensive emergency.
- tachycardia
- flushed skin
- palpitations
- diaphoresis
- weight loss
Differential Diagnosis
- hypertensive crisis
- sympathomimetic drug use (cocaine, amphetamine, PCP)
- withdrawal from alcohol, benzodiazepines, or narcotics
- serotonin syndrome
- autonomic neuropathy
- porphyria
Diagnosis
- plasma free metanephrines or urinary fractionated metanephrines
- CT imaging to localize tumor
- general lab features include hyperglycemia, hypercalcemia, and erythrocytosis
Management
- alpha blockade with phenoxybenzamine or phentolamine acutely
- beta blockade can be started 2 days later
- eventual surgical resection of tumor
Disposition
- admission to a monitored setting
See Also
External Links
References
- 1. Garg, M., Brar, K., Mittal, R., Kharb, S., & Gundgurthi, A. (2011). Medical management of pheochromocytoma: Role of the endocrinologist. Indian Journal Of Endocrinology And Metabolism, 15(8), 329. http://dx.doi.org/10.4103/2230-8210.86976
- 2. WJ Elliott, J Varon. Drugs used for the treatment of hypertensive emergencies. In: UpToDate, Post TW (Ed), UpToDate, Waltham, MA. (Accessed on January 11, 2016.)
- 3. DM Cline, AJ Machado (2015). "Systemic and Pulmonary Hypertension." Tintinalli's Emergency Medicine. Mcgraw-Hill Education.
- 4. Pheochromocytoma. (n.d.). In Wikipedia. Retrieved January 11, 2016, from http://en.wikipedia.org/wiki/pheochromocytoma