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Obstructive sleep apnea presenting as pseudopheochromocytoma: a case report
L J Hoy1, M Emery, J A Wedzicha
1Department of Endocrinology, St Bartholomew's Hospital, London, United Kingdom EC1A 7BE.
Summary
Obstructive sleep apnea (OSA) can mimic pheochromocytoma by causing high catecholamine levels. Treating OSA with CPAP normalized blood pressure and catecholamines in these patients.
Area of Science:
- Endocrinology
- Sleep Medicine
- Cardiology
Background:
- Repeated arousals in obstructive sleep apnea (OSA) lead to sustained sympathetic overactivity.
- Elevated 24-hour urinary catecholamine levels are a consequence of this sympathetic overactivity.
Observation:
- Five patients presented with clinical and biochemical profiles resembling pheochromocytoma.
- Extensive investigations ruled out catecholamine-secreting tumors in all patients.
- All diagnosed patients exhibited obstructive sleep apnea.
Findings:
- Obstructive sleep apnea (OSA) can manifest as pseudopheochromocytoma.
- Treatment of OSA using nasal continuous positive airway pressure (CPAP) normalized blood pressure.
- CPAP therapy also led to the normalization of urinary catecholamine levels.
Implications:
- Pseudopheochromocytoma is a rare but treatable presentation of OSA.
- Highlights the importance of considering OSA in patients with pheochromocytoma-like symptoms.
- CPAP therapy offers an effective treatment for OSA-induced pseudopheochromocytoma.