Document Detail

Unexplained symptomatic paroxysmal hypertension in pseudopheochromocytoma: a stress response disorder?
MedLine Citation:
PMID:  19120143     Owner:  NLM     Status:  MEDLINE    
Among overall numbers of patients tested for pheochromocytoma, less than 2% harbor the tumor. Among the rest, there is often no satisfactory explanation for the signs and symptoms leading to suspicion of pheochromocytoma. This group includes patients with severe symptomatic paroxysmal hypertension, often referred to as pseudopheochromocytoma, a condition that can be debilitating for patients and perplexing for clinicians. Similar to patients with the real tumor, patients with pseudopheochromocytoma can be misdiagnosed with panic disorder. However, pseudopheochromocytoma is characterized by an absence of panic or emotional distress preceding the onset of hypertension and symptoms of catecholamine excess. Because the clinical manifestations of pseudopheochromocytoma are similar, if not identical, to those due to excess circulating catecholamines in patients with the tumor, the most attractive explanation for the disorder is that it involves altered function of the autonomic nervous system. In line with this hypothesis, recent findings suggest that enhanced adrenal release of epinephrine and exaggerated cardiovascular responsiveness to catecholamines both contribute to the paroxysmal hypertension and symptoms of catecholamine excess in pseudopheochromocytoma. From this pattern, one would predict that therapeutic interventions that inhibit adrenal secretion of epinephrine or block adrenoceptor-mediated responses to catecholamines might provide a logical approach to therapy.
Graeme Eisenhofer; Yehonatan Sharabi; Karel Pacak
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of the New York Academy of Sciences     Volume:  1148     ISSN:  1749-6632     ISO Abbreviation:  Ann. N. Y. Acad. Sci.     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2009-01-05     Completed Date:  2009-01-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7506858     Medline TA:  Ann N Y Acad Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  469-78     Citation Subset:  IM    
Department of Medicine and Clinical Chemistry, University of Dresden, Dresden, Germany.
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MeSH Terms
Adrenal Gland Neoplasms / physiopathology,  therapy
Diagnosis, Differential
Epinephrine / metabolism
Hypertension / physiopathology*,  therapy
Panic Disorder / physiopathology
Pheochromocytoma / physiopathology*,  therapy
Stress Disorders, Traumatic / physiopathology*,  therapy
Stress, Psychological*
Reg. No./Substance:

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