Pheochromocytoma: Difference between revisions
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==Management== | ==Management== | ||
*Alpha blockade with phenoxybenzamine or phentolamine acutely | *Alpha blockade with phenoxybenzamine or phentolamine acutely<ref>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.)</ref> | ||
*Beta blockade can be started 2 days later | *Beta blockade can be started 2 days later | ||
*Eventual surgical resection of tumor | *Eventual surgical resection of tumor | ||
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<references/> | <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 | *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 | ||
Revision as of 12:38, 12 January 2016
Background
- Rare tumor arising from chromaffin cells in adrenal medulla or other paraganglia in the body
- Increased catecholamine production leading to its clinical manifestations
Clinical Features
- Headache
- Alternating periods of normal and elevated blood pressure, and can cause resistant hypertension and hypertensive emergency
- Tachycardia
- Flushed skin
- Palpitations
- Diaphoresis
- Weight loss
Differential Diagnosis
Hypertension
- Hypertensive emergency
- Stroke
- Sympathetic crashing acute pulmonary edema
- Ischemic stroke
- Intracranial hemorrhage
- Preeclampsia/Eclampsia
- Autonomic dysreflexia
- Scleroderma renal crisis
- Acute glomerulonephritis
- Type- I myocardial infarction
- Volume overload
- Urinary obstruction
- Drug use or overdose (e.g stimulants, especially alcohol, cocaine, or Synthroid)
- Renal Artery Stenosis
- Nephritic and nephrotic syndrome
- Polycystic kidney disease
- Tyramine reaction
- Cushing's syndrome
- Obstructive sleep apnea
- Pheochromocytoma
- Hyperaldosteronism
- Hyperthyroidism
- Anxiety
- Pain
- Oral contraceptive use
Diagnosis
- Plasma free metanephrines
- Urinary fractionated metanephrines
- CT imaging to localize tumor
- General lab features include hyperglycemia, hypercalcemia, and erythrocytosis
Management
- Alpha blockade with phenoxybenzamine or phentolamine acutely[1]
- Beta blockade can be started 2 days later
- Eventual surgical resection of tumor
Disposition
- Admission to a monitored setting
See Also
External Links
References
- ↑ 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.)
- 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