Severe arterial hypertension and hyperandrogenism in a boy: a rare case of catecholamine- and β-HCG-secreting pheochromocytoma
Journal Name: Journal of Pediatric Endocrinology and Metabolism Issue: Ahead of print
By HANS DUVEFELT, MD In medicine, contrary to common belief, it is not usually enough to know the diagnosis and its best treatment or procedure. Guidelines, checklists and protocols only go so far when you are treating real people with diverse constitutions for multiple problems under a variety of circumstances. The more you know about unusual presentations of common diseases, the more likely you are to make the correct diagnosis, I think everyone would agree. Also, the more you know about the rare diseases that can look like the common one you think you’re seeing in front if you, rather than having just a memo...
A 52-year-old male who had chronic hypertension for several years presented with abrupt epistaxis. The CT scan revealed a 40 mm × 40 mm mass in the nasal cavity intended to the maxillary sinus and the base of skull. Nasal endoscope biopsy and serum/urinary catecholamine detection conformed an ectopic noradrenaline-secreting pheochromocytoma. The present research was to discuss the clinical characteristics of the rare pheochromocytoma and the palliative interventional embolization for it.
This article summarizes current clinical approaches in patients with pheochromocytoma/paraganglioma.
CONCLUSIONS: Imaging, symptomatic and laboratory response to multimodal treatment including high dose 131 I-MIBG were achieved on long-term follow up in metastatic pheochromocytoma or paraganglioma. Imaging response at 3-6 months was prognostic. PMID: 31614368 [PubMed - as supplied by publisher]
ConclusionPheochromocytomas is a rare disease which may lead to a life-threathening hypertension as a result of elevated cathecolamine production. Initial recognition and appropriate management of pheochromocytomas are important. Preoperative management to normalize blood pressure followed by tumor removal has proved to be the ideal choice for good prognosis. Multidisciplinary team during preoperative, intraoperative and postoperative are required for successful outcome.
AbstractPurpose of ReviewThe present paper will review the results of experimental and clinical studies aimed at defining the functional behavior of the central and peripheral nervous system in adrenal pheochromocytoma.Recent FindingsThe contribution of sympathetic neural influences to the development of high blood pressure values in pheochromocytoma is complex. Studies performed in experimental animal models have shown that hypertension and the concomitant high circulating levels of catecholamines can lead to inhibition of central sympathetic neural outflow by reflex mechanisms and direct stimulation of central adrenergic...
CONCLUSIONS: Due to extreme rarity of pheochromocytoma in pregnancy, its impact on the mother and the fetus remains poorly understood. Official guidelines for treatment are not established, which, combined with the complex nature of the disease itself, demands a multidisciplinary and individualized approach. PMID: 31566249 [PubMed - as supplied by publisher]
Pheochromocytoma is a rare reason for hypertension. At least in younger people, an endocrinological workup of the etiology of hypertension is mandatory, as this case describes. If the pheochromocytomas are large enough, they can not only lead to hypertension but also cause direct damage to surrounding organs. AbstractPheochromocytoma is a rare reason for hypertension. At least in younger people, an endocrinological workup of the etiology of hypertension is mandatory, as this case describes. If the pheochromocytomas are large enough, they can not only lead to hypertension but also cause direct damage to surrounding organs.
Hypertension is a common clinical complication in pregnancy, representing possible short-term and long-term risks of complications for both mothers and babies. Even if in a majority of cases hypertension is essential, possible secondary causes, which can be related to endocrine disorders, must be detected and correctly managed. This review focuses on the evaluation and the management of primary hyperaldosteronism, Cushing syndrome, and pheochromocytoma in pregnancy.
Hypertension is one of the commonest chronic diseases contributing to cardiovascular disease. Idiopathic (primary) hypertension accounts for approximately 85% of the diagnosed cases, and 15% of hypertensive patients have other contributing conditions leading to elevated blood pressure (secondary hypertension). Endocrine hypertension is a common secondary cause of hypertension. The most common causes of endocrine hypertension are excess production of mineralocorticoids (ie, primary hyperaldosteronism), glucocorticoids (Cushing syndrome), and catecholamines (pheochromocytoma). After biochemical confirmation of hormonal exces...