Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0037315 (sleep apnea)
 8,000 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The treacherous and deceptive nature of pheochromocytoma makes it crucial to detect and treat it promptly; otherwise it will almost certainly be fatal from cardiovascular complications or metastases. Hypertension occurring in patients with pheochromocytomas is sustained in about 50% and paroxysmal in the remainder; however, many patients remain normotensive. Hypertension attacks may be precipitated by physical activity, postural changes, anxiety, certain foods or wine, some drugs, operative procedures, etc. Cardinal manifestations are paroxysmal hypertension, headache, palpitations +/- tachycardia, inappropriate sweating; anxiety, tremulousness, pallor (rarely flushing), chest and abdominal pains; nausea and vomiting often occur. Hypercatecholaminemia manifestations are more common and pronounced when paroxysmal hypertension occurs, but persons with familial pheochromocytoma may be asymptomatic. Protean manifestations of pheochromocytoma may simulate many conditions, some of which may have elevated plasma and urine catecholamines and their metabolites. Baro-reflex failure, postural tachycardia syndrome, sleep apnea, carcinoid, renal failure, and pseudopheochromocytoma may be diagnostic challenges. The history, physical examination, biochemical testing (after eliminating interfering drugs, when possible) for plasma and urinary metanephrines can usually establish or exclude presence of pheochromocytomas. Occasionally a clonidine suppression test is needed to differentiate neurogenic from pheochromocytic hypertension. Manifestations suggesting hypercatecholaminemia without hypertension are highly atypical of pheochromocytoma. Pheochromocytoma may present as panic attacks, pre-eclampsia, cardiomyopathy, infection with fever and leucocytosis, diabetes, migraine, shock, Cushing's syndrome, multiple organ failure with lactic acidosis, neurological manifestations, transitory electrocardiogram abnormalities, constipation, intestinal obstruction, visual impairment, convulsions, etc. The key to diagnosis is always to think of pheochromocytoma in the differential diagnosis of hypertension.
 ...
PMID:The protean manifestations of pheochromocytoma. 1924 99

An ectopic spleen occurs with less than 600 cases reported and has a large series of splenectomies less than 0.3%. Its highest prevalence occurs between 20 and 40 years of age, being more frequent in female patients. To present an original case report on the occurrence of ectopic spleen, mimicking hepatocellular carcinoma (HCC) after bariatric surgery. Occurrence of migratory spleen after late bariatric surgery, mimicking an HCC discovered in a routine evaluation. JCA patient, male, 66 years old, previously with sleep apnea, hypertensive and diabetic patients on medication regularly, who weighed 112.8 kg, with a BMI of 43.4 kg / m2. After 2 years of by-pass, a routine evaluation identified hepatobiliary surface on hepatic ultrasound performing MRI imaging suggestive of HCC. The team opted for a new laparoscopy with the possibility of cavity inventory beyond the biopsy of the tumor lesion already identified, to track intra-abdominal metastases and to review anatomy. The operation revealed that the suggestive lesion was subcapsular implanted only in the falciform and hepatic surface in segment amenable to total resection. The anatomopathological results of the lesions were described as congenital splenic cells compatible with ectopic spleen. The emergence of the ectopic spleen after laparoscopic bypass has not been reported so far because it is a non-traumatic surgery. The lesion in question had a benign behavior, with hepatic subcapsular implantation restricted to the falciform ligament, capable of total resection. Patient evolved well following follow up with gastroenterologist.
 ...
PMID:Ectopic spleen mimicking hepatocellular carcinoma in the late post-operative period of bariatric surgery. 3040 8