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Pheochromocytoma
From WikEM
Contents
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
- Asymptomatic hypertension
- Hypertensive urgency
- Hypertensive emergency
- Preeclampsia/Eclampsia
- Autonomic dysreflexia
- Drug use or overdose (e.g stimulants or Synthroid)
- Tyramine reaction
- Pheochromocytoma
- Hyperthyroidism
- Anxiety
Evaluation
- 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.)
