Typical symptoms of pheochromocytoma are hypertension, headaches, sweating, and weight loss. Preprint study from China found that 31% of patients with this rare NET did not have hypertension, which could lead to a missed or delayed diagnosis. MedTwitter
The authors identified clinical characteristics that distinguished the 31% of patients who were normotensive from the 69% withCompared with the hypertensive patients with pheochromocytoma, those with pheochromocytoma who were normotensive had the following characteristics:They were more likely to have an extra-adrenal pheochromocytoma.Their white blood cell counts and platelet counts were lower.Typical symptoms of pheochromocytoma are hypertension, headaches, sweating, and weight loss.
Recognition that pheochromocytoma can occur without hypertension could lead to earlier diagnoses, which could potentially avoid complications such as sudden cardiovascular and cerebrovascular events.The study included 524 consecutive patients who underwent surgical removal of pheochromocytoma from January 2009 to July 2018 at a single center.
The hypertensive patients were significantly older than those with normotension, with a mean age of 47 compared with 44 years. The duration during which the hypertensive patients had pheochromocytoma prior to undergoing surgery was significantly longer, at a mean of 53 months compared with 24 months.
Significantly more patients with hypertension had diabetes compared to those with normotension, at 25% vs 7%. Among those with hypertension, mean serum levels of norepinephrine and glucose were significantly higher, as were the white blood cell and platelet counts.The study did not investigate genetic differences between the patients with hypertension and those with normotension.The authors have disclosed no relevant financial relationships.
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