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[Arterial hypertension and increased urinary catecholamines]
Praxis
|October 6, 2000
Insights
A 39-year-old man with high blood pressure was diagnosed with cocaine-induced arterial hypertension. This case highlights the importance of considering drug use in diagnosing elevated urinary catecholamines.
Area of Science:
- Cardiology
- Nephrology
- Toxicology
Background:
- Arterial hypertension is a significant cardiovascular risk factor.
- Elevated urinary catecholamines can indicate phaeochromocytoma or other conditions.
- Refractory hypertension necessitates thorough diagnostic evaluation.
Observation:
- A 39-year-old male presented with persistent, difficult-to-treat arterial hypertension.
- Initial investigations focused on phaeochromocytoma due to elevated urinary free catecholamines.
- The patient's clinical presentation and work-up led to an alternative diagnosis.
Findings:
- The diagnostic work-up excluded phaeochromocytoma.
- Cocaine use was identified as the cause of the patient's arterial hypertension.
- This case underscores cocaine's hypertensive effects.
Implications:
- Clinicians should consider drug-induced causes, such as cocaine, in patients with refractory hypertension and elevated catecholamines.
- Understanding the pathogenesis of cocaine-induced hypertension is crucial for effective management.
- Differential diagnosis of elevated urinary catecholamines should include substance abuse.
Abstract:
We report the history of a 39-year-old-man who suffered from refractory arterial hypertension and who was referred to us for the diagnosis of phaeochromocytoma due to increased urinary free catecholamines. The work-up revealed the diagnosis of cocaine-induced arterial hypertension. The pathogenesis of cocaine-induced arterial hypertension as well as the differential diagnosis of increased urinary catecholamines will be discussed.