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Query: UMLS:C0016382 (flushing)
 6,387 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An intracardiac pheochromocytoma is extremely rare. This patient first presented postpartum at age 28 with clinical signs, symptoms and biochemical evidence suspicious for the diagnosis of pheochromocytoma. Multiple radiologic studies and laparotomy failed to confirm the diagnosis. Some 20 years later the patient presented with complaints of chest pain, palpitations, and flushing. Cardiac catheterization demonstrated a 'tumor blush' superior to the left atrium with a blood supply derived from the coronary arteries. Open-heart surgery was performed and the tumor successfully removed.
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PMID:Intracardiac pheochromocytoma with dual coronary blood supply: case report and literature review. 857 44

A 25-year-old woman, primigravida, developed the clinical picture of sporadic hypertension (blood pressure 120-230/70-130 mmHg), palpitations, flushing and sweating attacks at 34 weeks' gestation. A 24-hour urine collection revealed catechol levels consistent with a diagnosis of pheochromocytoma. The ultrasound and MRI showed a well-defined, rounded soft-tissue mass at the left suprarenal region. The hypertension was controlled with alpha-blockade. Antepartum fetal testing was normal. The patient underwent cesarean section at 38+1 weeks' gestation and delivered a 2,930-grams male with Apgar scores of 9 and 10 at one and five minutes. Left adrenalectomy was performed two weeks later. The pathologic diagnosis was pheochromocytoma.
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PMID:Pheochromocytoma in pregnancy: a case report. 870 14

Episodic vasomotor instability with flushing is an uncommon presentation that is suggestive of an endocrine etiology. This report is the case of a 42-year-old woman who presented to the ED 5 times in a 2-week period for recurrent, self-limited episodes of light-headedness associated with tachycardia, hypertension, and flushing. The patient's diagnosis eluded detection in both the outpatient and the inpatient settings for several months. The clinical diagnosis was ultimately confirmed by biochemical test samples obtained in the ED during a subsequent symptomatic event. The differential diagnosis of this patient's presentation includes pheochromocytoma, carcinoid syndrome, medullary thyroid carcinoma, systemic mastocytosis, and other endocrine and toxicologic diseases. ED management of the patient with transient yet significant vasomotor changes includes a workup for syncope, initiation of focused biochemical investigations, referral to the appropriate consultant, and consideration for admission.
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PMID:Recurrent near-syncope with flushing. 922 98

Twenty patients with the diagnosis of pheochromocytoma were studied from January 1990 to January 1998. Nineteen patients had a pathologic investigation performed. The mean age of patients was 49 +/- 16 years (range: 24-71 years), 8 males and 12 females. Nine cases corresponded to adrenal and eleven to extra-adrenal (paragangliomas) pheochromocytomas. The anatomic location was similar in both adrenal glands and for paragangliomas the cervical location predominated. The most consistent clinical finding in our patients was maintained arterial hypertension, followed by headache, palpitations and flushing. Biochemically, an increase in urine catecholamine levels or their metabolites was found in 82.2%. The clonidine test was very useful, particularly for cases where biochemical results were discrepant. CT, NMR and gammagraphy with 123I-MIBG have a high sensitivity for locating pheochromocytomas. NMR and gammagraphy with 111In-pentetreotide located cases in which CT or 123I-MIBG were negative. Preoperative treatment with adrenergic alpha-blockers allowed to surgery with no arterial tension complications. Only one patient with multiple abdominal paragangliomas relapsed. No differences regarding clinical manifestations, biochemical parameters or imaging studies were found between pheochromocytomas and paragangliomas, except their location.
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PMID:[A comparative study of 9 cases of adrenal pheochromocytoma and 11 cases of extra-adrenal pheochromocytoma]. 1043 7

The clinical syndrome of hypertension, headache, palpitation, diaphoresis, flushing, and emotional lability is classically associated with pheochromocytoma. Two patients are presented with this constellation of symptoms in whom investigations for pheochromocytoma were unrevealing. Headache was the presenting and most prominent complaint, with daily episodes of short-lasting, intermittent, and paroxysmal attacks. Each paroxysm of headache was associated with a dramatic increase in systolic and diastolic blood pressure. After failure to control the labile fluctuations in blood pressure and headache with several classes of anti-hypertensive medications used in combination, a prompt and persistent response occurred after the administration of clonidine. The pathophysiology of this syndrome and the mechanism of clonidine action are reviewed in the context of a possible failure of the baroreceptor reflex.
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PMID:Recurrent short-lasting headache associated with paroxysmal hypertension: a clonidine-responsive syndrome. 1103 47

We report a potential pitfall of 123I-metaiodobenzylguanine (MIBG) scan. Magnetic resonance imaging performed for other reasons, showed 2.5 cm tumor in the left adrenal gland. On questioning patient had episodic palpitations, flushing and hypertension suggestive of pheochromocytoma. Urinary metanephrine level was of borderline value but serum chromogranin A level was clearly elevated. 123I-MIBG scan showed accumulation of the tracer in the upper left abdomen and the finding was suspected to be intra-adrenal pheochromocytoma. During operation two separate tumors, adrenocortical adenoma in the left adrenal gland, and another smaller, extra-adrenal paraganglioma locating very close to the adenoma, were found. Thus the positive MIBG finding was caused by a paraganglioma with the concurrent presentation of nonfunctioning adrenocortical adenoma.
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PMID:A pitfall of metaiodobenzylguanidine scan: paraganglioma in close proximity to adrenocortical adenoma. 1295 37

A 44-year-old woman presented with sudden onset of chest pain, headache and nausea. Physical examination was remarkable for mild hypotension and tachycardia. ECG demonstrated sinus tachycardia with poor R wave progression in precordial leads and T wave inversion in leads V1-3. Cardiac enzymes were raised. Echocardiographic examination revealed normal cavity diameters with basal and mid left ventricular hypokinesia and an ejection fraction of 45%. A diagnosis of non-ST elevation myocardial infarction was made. A few orthostatic hypotensive attacks occurred at follow-up. A coronary angiogram showed normal coronary arteries. Within a few days, the echocardiographic findings, ECG and all cardiac markers had returned to normal. Two months later she presented with headache, palpitation, fever, neck swelling, flushing and hypertensive attacks. Phaeochromocytoma was diagnosed on the basis of increased metanephrine on urinalysis and a left suprarenal mass on CT scan.
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PMID:Phaeochromocytoma-induced myocarditis mimicking acute myocardial infarction. 1468 78

A 22-year-old woman complained of paroxysmal face flushing, palpitation and hypertension. CT scan revealed 55 mm mass in the right adrenal gland. Hormonal examination showed highly elevated urinary catecholamines and their metabolites excretion. Histological examination of the removed right adrenal gland confirmed the diagnosis of pheochromocytoma. 4 years later we observed the recurrence of similar symptoms. After the hormonal examination and CT imaging left adrenalectomy was performed, because of the presence of 33 mm diameter tumor in the left adrenal gland. Young age of our patient and occurence of bilateral pheochromocytomas suggested multiple endocrine neoplasia type 2. DNA sequence analysis of peripheral white blood cells revealed that codon 609 in exon 10 of the RET gene was mutated from TGC to CGC. During the further follow up of this patient we found 5 mm mass in the left lobe of the thyroid. Result of cytological examination of this focal mass and elevated calcitonin level in the pentagastrin test suggested the diagnosis of medullary thyroid cancer which was later confirmed after total thyeoidectomy based on results of histopathology of tumor. No metastatic changes was found. DNA analysis of the somatic mutation of the RET protooncogene was useful for the early detection of medullary thyroid cancer in the case of the 30-year-old patient with MEN 2A.
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PMID:[Late onset of medullary thyroid carcinoma with bilateral adrenal pheochromocytomas in the case of patient with MEN 2]. 1577 Nov 39

Flushing has been associated with medications, rosacea, menopause, carcinoid syndrome, pheochromocytoma, polycythemia, and mastocytosis, although it can occur without known cause. There are no known specific treatments available, but beta-blockers have suppressed flushing reactions in some patients, particularly when associated with anxiety. The medical histories and clinical characteristics of 9 patients with either idiopathic flushing or flushing associated with rosacea were reviewed. Eight patients experienced subjective improvement with propranolol therapy.
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PMID:Symptomatic treatment of idiopathic and rosacea-associated cutaneous flushing with propranolol. 1624 48

We present a case report that the patient had symptoms suggesting pheochromocytoma, a large tumor (> 50 g) and a single minimally altered laboratorial test, exemplifying a diagnostic pitfall. A 31 y.o. male patient had two acute abdominal events, the last one accompanied by headache, arterial hypertension, facial flushing, perspiration and cutaneous pallor. In another admission, the patient had sustained arterial hypertension and cardiac arrhythmia. From laboratory analysis, the vanililmandelic acid was slightly modified. Scintigraphy disclosed a large adrenal mass suggesting pheochromocytoma. Histopathology confirmed this hypothesis. This report points out that patients with symptoms suggesting pheochromocytoma, even when plasma catecholamines and urinary metanephrines levels are normal, may harbor large tumors with a high catecholamines turnover or that had undergone hemorrhagic necrosis.
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PMID:[Slight hormonal alterations in a patient with a large pheochromocytoma]. 1662 87


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