Info
🌱 來自: adrenal disorders
pheochromocytoma
Clinical manifestations (NEJM 2019;381:552)
-
Neuroendocrine neoplasm leads to inappropriate and paroxysmal release of adrenergic agents including epinephrine, norepinephrine, and rarely dopamine
-
Classic triad: 頭痛、心悸、流汗
- episodic headaches, palpitations and profuse sweating;
- only 50% have paroxysmal hypertension and most Pts do not have three classic sx
-
Paroxysms can be triggered by meds (eg, β-blockers 會引發), abdominal manipulation
-
Up to 40% of pheos/paragangliomas thought to have underlying genetic etiology; genetic testing frequently recommended
-
Associated with
- MEN2A/2B MEN2
- von Hippel-Lindau
- NF1
- familial paraganglioma (mutations in succinate dehydrogenase gene B, C and D),
- MAX or TMEM127 mutations
-
Treatment
- α-blockade first (usually phenoxybenzamine) ± β-blockade (often propranolol) → surgery
- Preoperative volume expansion is → critical due to possible hypotension after tumor excision
Backlink
- von Hippel Lindau
- von Hippel–Lindau
- pheochromocytoma and paraganglioma
- headache
- etiologies of dilated cardiomyopathy
- adrenal insufficiency
- adrenal incidentalomas
- adrenal disorders
- Precipitants-hypertensive crises
- PART 1 The Profession of Medicine
- Multiple Endocrine Neoplasia
- MEN
- MEN2
- I have a patient who is concerned that she has diabetes. How do I confirm the diagnosis and treat patients with diabetes
- Etiologies of hypercortisolism
- Etiologies of Classic FUO
- Endocrinology - Adrenal Disorders - Fast Facts NEJM Resident 360
- Emergency Medicine - Cardiopulmonary Emergencies - Fast Facts NEJM Resident 360
- Diseases of the Vasculature
- Diagnostic studies-pheochromocytoma and paraganglioma
- Diagnostic studies of pheochromocytoma
- Clinical manifestations-pheochromocytoma and paraganglioma
- Adrenal Masses
- Absent a Misdiagnosis, What Causes Treatment-Resistant Hypertension?