A Clinical Case of Pheochromocytoma Presenting with Decompensated Diabetes Mellitus and Paroxysmal Hypertension
Endokrinologya
; 27(4):261-265, 2022.
Article
in English
| EMBASE | ID: covidwho-2299606
ABSTRACT
Introduction:
Pheochromocytoma is a rare neuroendocrine tumor that originates from the adrenal medulla, less commonly from extraadrenal chromaffin cells (paraganglioma). In about 90% of cases, the tumor produces abnormal amounts of catecholamines. Pheochromocytomas are usually benign, but in rare cases can be malignant. Typical clinical manifestations are the result of the haemodynamic and metabolic effects of catecholamines and usually include paroxysmal hypertension with the classic triad (headache, excessive sweating, palpitations), carbohydrate disorders, etc. Elevated levels of catecholamine metabolites (metanephrine and normetanephrine) tested in plasma or in 24-hour urine confirm the diagnosis. Surgical removal of the tumor is the only radical treatment. Follow-up of patients postoperatively should be lifelong and performed by a multidisciplinary team in a specialized center of expertise. Case report A 36-year-old female patient referred to the clinic for decompensated diabetes mellitus. Detailed history revealed paroxysmal hypertension and the classic triad of pheochromocytoma. The diagnosis was confirmed by high urinary metanephrine levels and an abdominal CT scan, showing a tumor in the right adrenal gland with features typical of pheochromocytoma. Surgical removal of the pheochromocytoma and normalization of catecholamine levels led to normalization of blood pressure and reversal of diabetes mellitus. Conclusion(s) Pheochromocytoma is a difficult diagnosis in endocrinology practice as it can mimic many other diseases. Early detection and surgical removal of the tumor are crucial to avoid complications caused by elevated serum catecholamine levels.Copyright © 2022 Medical Information Center. All rights reserved.
diabetes mellitus; metanephrine; normetanephrine; pheochromocytoma; abdominal radiography; adrenal gland; adrenal pheochromocytoma/di [Diagnosis]; adrenal pheochromocytoma/su [Surgery]; adrenalectomy; adult; antihypertensive activity; article; blood pressure regulation; case report; clinical article; clinical feature; computer assisted tomography; coronavirus disease 2019; diabetes mellitus/di [Diagnosis]; diabetes mellitus/dt [Drug Therapy]; early cancer diagnosis; female; headache; heart palpitation; Holter monitoring; human; hyperhidrosis; hypertension/di [Diagnosis]; hypertension/dt [Drug Therapy]; hypertensive crisis/di [Diagnosis]; hypertensive crisis/dt [Drug Therapy]; insulin dependent diabetes mellitus/di [Diagnosis]; laparoscopic surgery; necrosis; oral glucose tolerance test; patient referral; urinalysis; amlodipine/dt [Drug Therapy]; C peptide/ec [Endogenous Compound]; catecholamine; doxazosin/dt [Drug Therapy]; glucose; metadrenalin/ec [Endogenous Compound]; metformin/dt [Drug Therapy]; metformin/po [Oral Drug Administration]; rilmenidine/dt [Drug Therapy]; vildagliptin/dt [Drug Therapy]; vildagliptin/po [Oral Drug Administration]; decompensated diabetes mellitus/di [Diagnosis]; decompensated diabetes mellitus/dt [Drug Therapy]; paroxysmal hypertension/di [Diagnosis]; paroxysmal hypertension/dt [Drug Therapy]
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Collection:
Databases of international organizations
Database:
EMBASE
Type of study:
Prognostic study
Language:
English
Journal:
Endokrinologya
Year:
2022
Document Type:
Article
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