Document Detail


Pheochromocytoma in a patient with end-stage renal disease.
MedLine Citation:
PMID:  11560309     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Pheochromocytoma is a rare tumor. To our knowledge only 15 cases have been reported in patients with end-stage renal disease (ESRD). We describe a 46-year-old woman with ESRD and a history of paroxysmal and difficult-to-control hypertension. During anesthesia for a surgical procedure, the patient experienced blood pressure lability with systolic blood pressures ranging from 76 to 360 mm Hg. Serum catecholamine concentrations were 2,698 pg/ mL (reference value, <750 pg/mL) for norepinephrine, 33 pg/mL (<110 pg/mL) for epinephrine, and 55 pg/mL (<30 pg/mL) for dopamine. The concentrations of plasma metanephrines were 6.84 nmol/L (<0.50 nmol/L) for metanephrine and 14.64 nmol/L (<0.90 nmol/L) for normetanephrine. Abdominal computed tomography showed a right-sided, 4-cm mass posterior to the infrahepatic inferior vena cava. Following blood pressure control with alpha- and beta-adrenergic blockade, the mass was removed. Pathologic examination demonstrated the mass was a pheochromocytoma. The maximum postoperative systolic blood pressure was 160 mm Hg. Postoperative plasma normetanephrine concentration was 2.80 nmol/L, and metanephrine was obscured by interfering substances. This case report and literature review emphasizes the difficulty in diagnosing pheochromocytomas in patients with ESRD despite the myriad of available diagnostic tests.
Authors:
J A Godfrey; O B Rickman; A W Williams; G B Thompson; W F Young
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Mayo Clinic proceedings. Mayo Clinic     Volume:  76     ISSN:  0025-6196     ISO Abbreviation:  Mayo Clin. Proc.     Publication Date:  2001 Sep 
Date Detail:
Created Date:  2001-09-18     Completed Date:  2001-12-04     Revised Date:  2007-10-29    
Medline Journal Info:
Nlm Unique ID:  0405543     Medline TA:  Mayo Clin Proc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  953-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Internal Medicine, Mayo Clinic, Rochester, Minn 55905, USA.
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MeSH Terms
Descriptor/Qualifier:
Blood Chemical Analysis
Female
Follow-Up Studies
Humans
Kidney Failure, Chronic / complications*,  diagnosis,  therapy
Middle Aged
Pheochromocytoma / complications*,  diagnosis*,  surgery
Renal Dialysis
Tomography, X-Ray Computed
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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