[Pseudo pheochromocytoma induced by professional stress: A case report]. / Un pseudophéochromocytome induit par le stress professionnel ; à propos d'un cas.

INTRODUCTION: An elevation of plasma or urinary catecholamines or their metabolites in the context of a suspicion of a secondary hypertension associated with paroxysms generally leads to the diagnosis of pheochromocytoma. However, this is not always true. CASE REPORT: We report the case of a 39-year old man with a severe hypertension that was resistant to drug therapy and associated with paroxysms. Urinary fractioned metanephrines were elevated. However, no tumor could be found on tomodensitometry and MIBG scintigraphy. Thus, the causes of pseudopheochromocytoma were reviewed and the diagnosis of professional stress was finally held. In fact, his professional redeployment resulted in an improvement of blood pressure levels, the disappearance of paroxysms and the normalization of urinary metanephrines. CONCLUSION: This observation involves professional stress in pseudo pheochromocytoma.

[Association of renovascular hypertension and primary aldosteronism]. / Association d'une hypertension artérielle rénovasculaire et d'un hyperaldostéronisme primaire.

INTRODUCTION: Renal artery stenosis is rarely associated with Conn adenoma. CASE REPORT: We report a 27-year-old male patient who presented in 2001 with a severe high blood pressure associated with hypokaliemia. Radiologic investigations showed a left renal artery stenosis with agenesis of left kidney. A left nephrectomy was performed and blood pressure returned to normal with a single antihypertensive drug. Five years later, the patient again presented with severe high blood pressure. Laboratory studies revealed a low serum potassium level at 2.8 mmol/L associated with high urinary potassium excretion (84 mmol/24h) and a very high aldosterone/renin ratio (>462). Abdominal CT scan demonstrated a right adrenal mass. The patient underwent a right adrenalectomy (adenoma). Blood pressure returned to normal with a single antihypertensive. Serum potassium levels as well as aldosterone/renin ratio normalized. CONCLUSION: We discussed whether the association between these two entities is merely fortuitous or conversely based on a causal relationship.

[Rupture of the excretory urinary tract due to a lithiasis of the pelvic ureter]. / Rupture de la voie excrétrice urinaire sur lithiase de l'uretère pelvien.

A case of rupture of the urinary tract related to lithiasis of the pelvic ureter is reported. Outcome was favorable after percutaneous drainage of the urinoma and removal of the stone using a Dormia catheter. Clinical diagnosis was readily established on the patient's history and on ultrasound and intravenous urogram findings.