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Obstructive sleep apnea presenting as pseudopheochromocytoma.

Michael K Cheezum¹, Christopher J Lettieri

¹Department of Medicine, Critical Care and Sleep Medicine, Walter Reed Army Medical Center Washington, DC. USA.

Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine

|April 24, 2010

Summary

Severe obstructive sleep apnea can mimic pheochromocytoma, causing symptoms like fatigue and palpitations. Treating sleep apnea resolved these symptoms and normalized catecholamine levels in one patient.

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Area of Science:

Internal Medicine
Pulmonology
Endocrinology

Background:

Hypertension and symptoms like fatigue, somnolence, diaphoresis, and palpitations can indicate pheochromocytoma.
Pheochromocytoma is a rare tumor causing excess catecholamine release.

Observation:

A patient with hypertension presented with symptoms mimicking pheochromocytoma, but imaging was negative.
Polysomnography revealed severe obstructive sleep apnea (apnea-hypopnea index of 112 events/h).

Findings:

Continuous positive airway pressure (CPAP) therapy led to symptom resolution, improved blood pressure, and normalized urinary catecholamines.
This suggests obstructive sleep apnea can cause pseudopheochromocytoma.

Implications:

Sleep disordered breathing should be considered in patients with suspected pheochromocytoma and negative imaging.
Effective treatment of obstructive sleep apnea may resolve pseudopheochromocytoma symptoms and biochemical abnormalities.