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Catecholamine excess: pseudopheochromocytoma and beyond.

Amarinder S Garcha1, Debbie L Cohen1

  • 1Renal, Electrolyte and Hypertension Division, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.

Advances in Chronic Kidney Disease
|April 25, 2015
PubMed
Summary
This summary is machine-generated.

Pseudopheochromocytoma mimics pheochromocytoma symptoms like episodic hypertension. Management involves addressing amplified cardiovascular response to catecholamines and sympathetic overactivity.

Keywords:
Catecholamine excessLabile hypertensionPheochromocytomaPseudopheochromocytomaRenalase

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Area of Science:

  • Endocrinology
  • Cardiology
  • Neuroscience

Background:

  • Symptoms of catecholamine excess, such as episodic hypertension, can mimic pheochromocytoma.
  • Pseudopheochromocytoma presents a diagnostic challenge, often with negative evaluations for pheochromocytoma.
  • Differential diagnosis must exclude stress, autonomic dysfunction, medications, and illicit drugs as causes of catecholamine excess.

Purpose of the Study:

  • To differentiate pseudopheochromocytoma from pheochromocytoma.
  • To understand the pathophysiology of amplified cardiovascular response in pseudopheochromocytoma.
  • To outline management strategies for pseudopheochromocytoma.

Main Methods:

  • Clinical presentation analysis of patients with symptoms of catecholamine excess.
  • Exclusion of secondary causes of hypertension and catecholamine excess.
  • Assessment of cardiovascular responsiveness to catecholamines and sympathetic nervous system activity.

Main Results:

  • Patients exhibit amplified cardiovascular responsiveness to catecholamines and enhanced sympathetic stimulation.
  • Increased secretion of dopamine, epinephrine, and norepinephrine, and their metabolites contribute to the clinical presentation.
  • Hemodynamic presentations vary based on the specific elevated catecholamine.

Conclusions:

  • Pseudopheochromocytoma requires careful exclusion of other causes of catecholamine excess.
  • Management often involves medications targeting sympathetic nervous system activity.
  • Anxiolytics, antidepressants, and psychotherapy are crucial for symptom management.