Be wary of a mature adult, who presents with a parent

The importance of interviewing a patient alone cannot be overemphasised, especially when a mature adult patient presents with a parent. We present the case of a 47-year-old man who was seen in the outpatient clinic with his mother, as his general practitioner (GP) was concerned whether he had a pheochromocytoma. The GP had arranged a CT scan of the abdomen, to investigate for an abdominal cause for oedematous legs. This had picked a benign growth in the right adrenal gland. A 24-hour urinary normetanephrine level checked was raised. Further tests and regular monitoring showed persistently raised levels of catecholamines to the point that adrenalectomy was being considered. He was always accompanied by his mother except on the clinic visit, when he admitted to taking amphetamine. Urinary catecholamine levels normalised, after he stopped taking it.