Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0031511 (pheochromocytoma)
 14,622 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

23 patients presenting with symptoms of pheochromocytoma were subjected to the clonidine suppression test. In 6 patients, in whom a pheochromocytoma was surgically approved later on, norepinephrine was not suppressed by clonidine. 17 patients in whom a secondary form of hypertension could be excluded by other diagnostic measures showed a marked decrease of plasma norepinephrine. Apart from drowsiness, no adverse side effects were observed. In our hands, the clonidine test proved as a safe and specific test in the diagnosis of pheochromocytoma.
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PMID:Preliminary results with the clonidine suppression test in the diagnosis of pheochromocytoma. 405 24

The pharmacology, pharmacokinetics, therapeutic and diagnostic uses, toxicity, adverse reactions, and contraindications of metoclopramide are reviewed. Metoclopramide enhances the rate of gastric emptying by (1) augmenting esophageal peristalsis, gastric antral contractions, and small intestine transit time and (2) increasing resting pressures of the lower esophageal and pyloric sphincters. The drug does not stimulate gastric acid secretions. The injectable form is approved for use to facilitate intubation of the small intestine and the passage of barium into the intestine for radiographic procedures. Tablets are approved for the treatment of symptoms associated with diabetic gastroparesis. The drug has been used in the treatment of vomiting of various etiologies. The side effects of metoclopramide are usually mild, transient, and reversible with discontinuation of the drug. They include drowsiness, GI disturbances, extrapyramidal reactions, and increased lactation. Metoclopramide should not be given in combination with MAO inhibitors, tricyclic antidepressants, sympathomimetic amines, or to patients with pheochromocytoma, GI hemorrhage, obstruction, or perforation. Metoclopramide appears to be an effective drug in stimulating the mobility of the upper gastrointestinal tract without increasing gastric secretions. Further studies are needed to assess its value in the treatment of vomiting secondary to anesthesia and chemotherapy, and to assess its precise role in the treatment of diabetic gastroparesis.
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PMID:Review of a new gastrointestinal drug--metoclopramide. 701 32

Paragangliomas of the head and neck arise from collections of cells from the neural crest associated with cranial or sympathetic nerves. Such lesions are rare in children. The majority of paragangliomas in the paediatric age groups have been familial, occurring in association with an adrenal pheochromocytoma. Children typically present with a neck mass and systemic evidence of catecholamine hypersecretion. We present the case of a 12-year-old boy with a history of increasing headache, drowsiness and Horner's syndrome for 8 months. The patient underwent exploration of the neck mass under general anaesthesia. The lesion was found to be in continuity with the left sympathetic chain. It was highly vascular but was removed en mass and sent for histological analysis. The histology showed that the mass was a well-circumscribed encapsulated tumour and that complete excision was achieved. The post-operative period was uneventful and the patient recovered well after the operation. On review at 6 months following surgery, his scars were maturing satisfactorily but the Horner's syndrome was persistent. Sympathetic chain paragangliomas are very rare tumours in the head and neck but should be considered in the differential diagnosis when clinical and radiographic evidence suggest a paraganglioma. The presentation is typically of a slow-growing neck mass with the presence of an ipsilateral Horner's syndrome. To our knowledge, this is the first reported case of a sympathetic chain paraganglioma in a child.
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PMID:Sympathetic paraganglioma presenting with Horner's syndrome in a child. 1678 77

A 39-year-old man with a history of poorly controlled hypertension presented with a 2-year history of fatigue, daytime somnolence, and intermittent episodes of diaphoresis and palpitations. Episodes were self-limiting, lasting approximately 5-10 minutes and occurred several times per month, most notably at night. Laboratory evaluation was significant for elevated 24-h urinary catecholamine levels, suggestive of pheochromocytoma. However, thorough imaging failed to identify a catecholamine-secreting tumor. Subsequent polysomnography revealed severe obstructive sleep apnea, with an apnea-hypopnea index of 112 events/h. After one month of continuous positive airway pressure therapy, the patient experienced resolution of his presenting symptoms, improved blood pressure control and normalization of his urinary catecholamine levels. This case highlights sleep disordered breathing as a potentially reversible cause of pseudopheochromocytoma.
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PMID:Obstructive sleep apnea presenting as pseudopheochromocytoma. 2041 98

A 36-year-old active duty male with migraine headaches presented for evaluation of poorly controlled hypertension. The workup included an endocrinological examination, which revealed a moderately elevated urine normetanephrine level, suggesting the possibility of a pheochromocytoma. The evaluation also included a sleep study for possible obstructive sleep apnea (OSA) because of a history of snoring, apneic episodes, and daytime somnolence. The sleep study confirmed the diagnosis of OSA. The patient was treated with continuous positive airway pressure therapy and a plasma normetanephrine level demonstrated improvement, but persistent elevation. The patient was noted to be taking amitriptyline for migraine headache prevention. With approval from Neurology, the medication was discontinued and a repeat urine normetanephrine level revealed normalization. This case demonstrates the well-documented medication-associated false-positive test result that can be seen in patients taking tricyclic antidepressants. Tricyclic antidepressants, along with phenoxybenzamine, account for 41 to 45% of all elevated metanephrine and normetanephrine levels in patients without pheochromocytoma. This case also shows that patients with OSA can develop hypertension through elevated sympathetic tone, mimicking a pheochromocytoma. Treatment with continuous positive airway pressure therapy is recommended to not only improve hypertension and catecholamine excess but also distinguish the condition from a pheochromocytoma.
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PMID:Obstructive sleep apnea and tricyclic antidepressant use presenting as a pseudopheochromocytoma in an active duty sailor: a case report. 2440 97

A 52-year-old female with a history of poorly controlled resistant hypertension was admitted to our hospital with severe hypertension. She had a history of fatigue and intermittent episodes of palpitations. Laboratory evaluation was significant for elevated 24-h urinary catecholamine levels (3,5 times the upper normal levels). This case was presenting with a clinical and biochemical picture indistinguishable from that of pheochromocytoma. However, neither computed tomography nor meta-iodo-benzyl-guanidine scintigraphy detected any catecholamine-producing tumor in or outside the adrenal glands. Our patient was screened with full polysomnography because of heavy snoring, daytime somnolence and obesity. It revealed severe obstructive sleep apnea syndrome. After three months of continuous positive airway pressure therapy, the patient experienced resolution of his presenting symptoms, improved blood pressure control and normalization of his urinary catecholamine levels. This case highlights sleep disordered breathing as a potentially reversible cause of pseudo-pheochromocytoma.
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PMID:Obstructive sleep apnea presenting as pseudopheochromocytoma. 2721 98