Pheochromocytoma as a cause of secondary arterial hypertension
| Autor: | Bojan Pavković, Bojan Prokić, Aleksandra Huljić, Marija Zarić, Aleksandra Caričić, Milica Kuljanin |
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| Rok vydání: | 2018 |
| Předmět: | |
| Zdroj: | Timocki medicinski glasnik. 43:22-25 |
| ISSN: | 2406-1042 0350-2899 |
| Popis: | Pheohromocytoma is a catecholamine-secreting tumor and it is most commonly found in the adrenal glands, but can also be found outside of them. Generally benign, it has malignant potential in about 10% of all cases. Represents a rare cause of secondary arterial hypertension (HTA). It occurs in 0.1% of all HTA cases. A case study of a young man with secondary HTA caused by pheochromocytoma. Retrospective analysis of the patient's medical record was done. A 37-year-old patient reported to the doctor because of occasionally elevated arterial blood pressure (TA) levels in self-measurement, followed by headache, redness in the face, frequent epistaxis and weight loss. From anamnestic data we found a recreational athlete, a non-smoker, and no hereditary risk factors for cardiovascular disease. The physical finding at the first examination is neat, except for the TA level of 210/110 mmHg. The ECG registered 108 bpm sinus tachycardia. TA was ambulantory regulated by oral therapy, and the patient was proceed to laboratory analysis of blood and urine and an echosonographic examination of the abdomen. On the control check TA was 180/95 mmHg, laboratory findings in the reference range, other than glycemia of 11.3 mmol/L. Abdominal echosonography revealed tumor mass in the area of the right adrenal lodge. After repeated hyperglycemia and HbA1c elevated level oral antidiabetics and antihypertensive therapy by ACE inhibitor were prescribed. Patient was sent to the endocrine surgeon due to described tumor mass. MDCT scan and MRI finding of the adrenal loudge confirm the presence of tumor mass in the right adrenal gland. Additional laboratory findings showed elevated levels of metanefrin and chromogranin A in plasma, and a higher levels of degradation products of catecholamines (vanilmendelic acid and metanefrine) in 24h-urine was detected. Based on clinical phenomenology and the findings of additional diagnostic procedures, a suspicion of pheochromocytoma was raised and surgical treatment was indicated. The tumor mass was operationally removed. Pathohistological findings confirmed the diagnosis. The patient was released in good general condition with prescribed antihypertensive and antidiabetic therapy. In the period of one-year postoperative follow-up, the primary disease remained without relapse, TA was adequately medicamenotous regulated, and laboratory findings was within the reference range. In the etiological consideration of elevated TA values in younger individuals it is also important to keep in mind the rare causes such as pheochromocytoma. With timely diagnosis and adequate treatment, a patient's cure can be achieved, while unrecognized cases can result in a fatal outcome. |
| Databáze: | OpenAIRE |
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