Document Detail

Pheochromocytoma, chronic renal insufficiency, and hemodialysis: a combination leading to a diagnostic and therapeutic dilemma.
MedLine Citation:
PMID:  9124748     Owner:  NLM     Status:  MEDLINE    
Pheochromocytomas are functioning paragangliomas often presenting with paroxysmal hypertension due to catecholamine secretion. The preferential diagnostic workup includes urine and serum catecholamine measurements. Therapeutic management consists of pharmacologic cardiovascular manipulation and volume expansion with subsequent surgical resection. We have encountered a symptomatic pheochromocytoma in a chronic renal insufficiency patient on hemodialysis. The diagnostic dilemma arose due to the patient's anuric status and the inherent increase in serum catecholamine levels noted in anuric patients. The therapeutic dilemma arose in the proper pharmacologic management and volume expansion in this patient on hemodialysis. The patient underwent successful resection of the pheochromocytoma and has done well. An analysis of our diagnostic and therapeutic processes as well as a review of the literature are presented to assist in the management of this difficult clinical situation.
J C Box; M D Braithwaite; T Duncan; G Lucas
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The American surgeon     Volume:  63     ISSN:  0003-1348     ISO Abbreviation:  Am Surg     Publication Date:  1997 Apr 
Date Detail:
Created Date:  1997-04-24     Completed Date:  1997-04-24     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370522     Medline TA:  Am Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  314-6     Citation Subset:  IM    
Department of Surgery, Georgia Baptist Medical Center, Atlanta, USA.
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MeSH Terms
Adrenal Gland Neoplasms / complications,  diagnosis*,  rehabilitation
Hypertension / etiology
Kidney Failure, Chronic / complications*,  therapy
Middle Aged
Pheochromocytoma / complications,  diagnosis*,  rehabilitation
Renal Dialysis*

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