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[Arterial hypertension and increased urinary catecholamines].

I Koneth1, P M Suter, W Vetter

  • 1Departement für Innere Medizin, Universitätsspital Zürich.

Praxis
|October 6, 2000
PubMed
Summary

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.

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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.

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