Pheochromocytoma history and symptoms: Difference between revisions
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*[[Sweating]] | *[[Sweating]] | ||
*[[Headaches]] occurs in 90 % of patients. | *[[Headaches]] occurs in 90 % of patients. | ||
*Paroxysmal attacks of [[hypertension]] but some patients have normal [[blood pressure]] | *Paroxysmal attacks of [[hypertension]] but some patients have normal [[blood pressure]] ([[headache]], [[Blurred vision|blurry vision]], [[nausea]]) | ||
*Pheochromocytoma may be [[asymptomatic]] and discovered incidentally after [[Screening (medicine)|screening]] for [[MEN, type 2|MEN]] patients | *Pheochromocytoma may be [[asymptomatic]] and discovered incidentally after [[Screening (medicine)|screening]] for [[MEN, type 2|MEN]] patients | ||
=== Less common symptoms === | === Less common symptoms === | ||
Less common symptoms of pheochromocytoma include: | Less common symptoms of pheochromocytoma include: | ||
* [[Cardiomyopathy]]: | * [[Cardiomyopathy]]: [[dyspnea on exertion]], [[leg swelling]], painful [[hepatomegaly]].<ref name="pmid19158054">{{cite journal| author=Kassim TA, Clarke DD, Mai VQ, Clyde PW, Mohamed Shakir KM| title=Catecholamine-induced cardiomyopathy. | journal=Endocr Pract | year= 2008 | volume= 14 | issue= 9 | pages= 1137-49 | pmid=19158054 | doi=10.4158/EP.14.9.1137 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19158054 }}</ref> | ||
* Episodic [[hypotension]].<ref name="pmid8076587">{{cite journal| author=Bravo EL| title=Evolving concepts in the pathophysiology, diagnosis, and treatment of pheochromocytoma. | journal=Endocr Rev | year= 1994 | volume= 15 | issue= 3 | pages= 356-68 | pmid=8076587 | doi=10.1210/edrv-15-3-356 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8076587 }}</ref> | * Episodic [[hypotension]].<ref name="pmid8076587">{{cite journal| author=Bravo EL| title=Evolving concepts in the pathophysiology, diagnosis, and treatment of pheochromocytoma. | journal=Endocr Rev | year= 1994 | volume= 15 | issue= 3 | pages= 356-68 | pmid=8076587 | doi=10.1210/edrv-15-3-356 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8076587 }}</ref> | ||
| Line 36: | Line 36: | ||
* [[Marfan's syndrome|Marfanoid features]] | * [[Marfan's syndrome|Marfanoid features]] | ||
* [[Medullary thyroid cancer]] | * [[Medullary thyroid cancer]] | ||
* The patient may show symptoms associated with [[Von Hippel-Lindau Disease|von Hippel-Lindau]]: The mean age at presentation is about 30 years. The onset can sometimes be before the age of 10. <ref name="pmid10458336">{{cite journal| author=Walther MM, Reiter R, Keiser HR, Choyke PL, Venzon D, Hurley K et al.| title=Clinical and genetic characterization of pheochromocytoma in von Hippel-Lindau families: comparison with sporadic pheochromocytoma gives insight into natural history of pheochromocytoma. | journal=J Urol | year= 1999 | volume= 162 | issue= 3 Pt 1 | pages= 659-64 | pmid=10458336 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10458336 }}</ref> | * The patient may show [[symptoms]] associated with [[Von Hippel-Lindau Disease|von Hippel-Lindau]]: The mean age at presentation is about 30 years. The onset can sometimes be before the age of 10. <ref name="pmid10458336">{{cite journal| author=Walther MM, Reiter R, Keiser HR, Choyke PL, Venzon D, Hurley K et al.| title=Clinical and genetic characterization of pheochromocytoma in von Hippel-Lindau families: comparison with sporadic pheochromocytoma gives insight into natural history of pheochromocytoma. | journal=J Urol | year= 1999 | volume= 162 | issue= 3 Pt 1 | pages= 659-64 | pmid=10458336 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10458336 }}</ref> | ||
=References= | =References= | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ahmad Al Maradni, M.D. [2]Mohammed Abdelwahed M.D[3]
Overview
Common symptoms of pheochromocytoma include episodes of palpitations, sweating and headaches.[1] Most patients are asymptomatic. Less common symptoms include cardiomypathy and episodic hypotension.[2] Patients may have a history of recurrent attacks of palpitation or family history of pheochromocytoma. Patients may show symptoms of other multiple endocrine neoplasias associated diseases such as that of medullary thyroid cancer and hyperparathyroidism.
History
Past medical history
- Patients suffering from pheochromocytoma may have a positive past medical history of recurrent attacks of palpitation or panic attacks.
Family history
- Family history of MEN2B increases chances of familial pheochromocytoma.
Symptoms
Common symptoms
Common symptoms of pheochromocytoma are secondary to sympathetic nervous system hyperactivity. Symptoms usually subside in less than one hour and they may include:
- Palpitations especially in epinephrine producing tumors.[3]
- Anxiety often resembling that of a panic attack
- Sweating
- Headaches occurs in 90 % of patients.
- Paroxysmal attacks of hypertension but some patients have normal blood pressure (headache, blurry vision, nausea)
- Pheochromocytoma may be asymptomatic and discovered incidentally after screening for MEN patients
Less common symptoms
Less common symptoms of pheochromocytoma include:
- Cardiomyopathy: dyspnea on exertion, leg swelling, painful hepatomegaly.[4]
- Episodic hypotension.[5]
Symptoms of associated diseases
Pheochromocytoma patients may show symptoms of other diseases in MEN 2 syndromes such as:
- Hyperparathyroidism
- Marfanoid features
- Medullary thyroid cancer
- The patient may show symptoms associated with von Hippel-Lindau: The mean age at presentation is about 30 years. The onset can sometimes be before the age of 10. [6]
References
- ↑ Stein PP, Black HR (1991). "A simplified diagnostic approach to pheochromocytoma. A review of the literature and report of one institution's experience". Medicine (Baltimore). 70 (1): 46–66. PMID 1988766.
- ↑ Baguet JP, Hammer L, Mazzuco TL, Chabre O, Mallion JM, Sturm N; et al. (2004). "Circumstances of discovery of phaeochromocytoma: a retrospective study of 41 consecutive patients". Eur J Endocrinol. 150 (5): 681–6. PMID 15132724.
- ↑ Bravo EL, Gifford RW (1993). "Pheochromocytoma". Endocrinol Metab Clin North Am. 22 (2): 329–41. PMID 8325290.
- ↑ Kassim TA, Clarke DD, Mai VQ, Clyde PW, Mohamed Shakir KM (2008). "Catecholamine-induced cardiomyopathy". Endocr Pract. 14 (9): 1137–49. doi:10.4158/EP.14.9.1137. PMID 19158054.
- ↑ Bravo EL (1994). "Evolving concepts in the pathophysiology, diagnosis, and treatment of pheochromocytoma". Endocr Rev. 15 (3): 356–68. doi:10.1210/edrv-15-3-356. PMID 8076587.
- ↑ Walther MM, Reiter R, Keiser HR, Choyke PL, Venzon D, Hurley K; et al. (1999). "Clinical and genetic characterization of pheochromocytoma in von Hippel-Lindau families: comparison with sporadic pheochromocytoma gives insight into natural history of pheochromocytoma". J Urol. 162 (3 Pt 1): 659–64. PMID 10458336.