[PSEUDOPHEOCHROMOCYTOMA - AN UNCOMMON FORM OF HYPERTENSION]

Pseudopheochromocytoma is an uncommon form of hypertension. In contrast to the more well-known pheochromocytoma, no unequivocal etiologic factor or a clear physiological abnormality can be identified. This disorder manifests in sudden, recurrent, episodes of significant, sometimes extreme, increase in blood pressure, both systolic and diastolic, lasting from minutes to hours, with no consistent trigger that the patient or the doctor is aware of, and is accompanied by typical symptoms. These symptoms include, but are not limited to, headaches, fever, flushing, weakness, with or without an accelerated heart rate. Patients with this disorder have increased sympathetic activity, from an adrenal source or sympathetic nerve endings, as well as hyper-responsiveness of the heart and blood vessels to this activation. There is an increased secretion of epinephrine and dopamine in the case of an adrenal source, and norepinephrine in the case of the sympathetic nerve endings. It is important to perform the differential diagnosis of this condition to rule out pheochromocytoma by testing plasma and urinary metanephrines. Additional diagnoses that need to be excluded are anxiety attacks, fluctuating-episodic hypertension, and baroreflex failure. The therapeutic approach of this disorder includes a combination of drugs to lower and control blood pressure, especially drugs that block alpha and beta-adrenergic receptors, along with antianxiety and antidepressants. Psychological intervention, as well as techniques that are aimed to reduce anxiety, have a place in therapy, especially among those patients who can relate the manifestations of the disorder to mental and emotional factors that contribute to the clinical manifestations.