Endocrinology, diabetes & metabolism case reports, 2022-02, Vol.2022 (1), p.1-4
2022
Details
- Autor(en) / Beteiligte
- Titel
- Pseudo-pheochromocytoma due to obstructive sleep apnea: a case report
- Ist Teil von
- Endocrinology, diabetes & metabolism case reports, 2022-02, Vol.2022 (1), p.1-4
- Ort / Verlag
- England: Bioscientifica Ltd
- Erscheinungsjahr
- 2022
- Link zum Volltext
- Quelle
- EZB Free E-Journals
- Beschreibungen/Notizen
- Summary Obstructive sleep apnea (OSA) is a condition of intermittent nocturnal upper airway obstruction. OSA increases sympathetic drive which may result in clinical and biochemical features suggestive of pheochromocytoma. We present the case of a 65-year-old male with a 2.9-cm left adrenal incidentaloma on CT, hypertension, symptoms of headache, anxiety and diaphoresis, and persistently elevated 24-h urine norepinephrine (initially 818 nmol/day (89–470)) and normetanephrine (initially 11.2 µmol/day (0.6–2.7)). He was started on prazosin and underwent left adrenalectomy. Pathology revealed an adrenal corticoadenoma with no evidence of pheochromocytoma. Over the next 2 years, urine norepinephrine and normetanephrine remained significantly elevated with no MIBG avid disease. Years later, he was diagnosed with severe OSA and treated with continuous positive airway pressure. Urine testing done once OSA was well controlled revealed complete normalization of urine norepinephrine and normetanephrine with substantial symptom improvement. It was concluded that the patient never had a pheochromocytoma but rather an adrenal adenoma with biochemistry and symptoms suggestive of pheochromocytoma due to untreated severe OSA. Pseudo-pheochromocytoma is a rare presentation of OSA and should be considered on the differential of elevated urine catecholamines and metanephrines in the right clinical setting. Learning points Obstructive sleep apnea (OSA) is a common condition among adults. OSA may rarely present as pseudo-pheochromocytoma with symptoms of pallor, palpitations, perspiration, headache, or anxiety. OSA should be considered on the differential of elevated urine catecholamines and metanephrines, especially in patients with negative metaiodobenzylguanidine (MIBG) scan results.
- Sprache
- Englisch
- Identifikatoren
- ISSN: 2052-0573eISSN: 2052-0573DOI: 10.1530/EDM-21-0100Titel-ID: cdi_doaj_primary_oai_doaj_org_article_5c15b0c4d96a471db5d0305c5aaf477e
- Format
- –
- Schlagworte
- Abdominal adiposity, Abdominal cramp, Abdominal discomfort, Abdominal distension, Abdominal guarding, Abdominal lump, Abdominal pain, Abdominal tenderness, Abdominal wall defects, Aberrant adrenal receptors, Abiraterone, Abnormal posture, Abrasion, Abscess, Abscess drainage, Acalculia, Acanthosis Nigricans, Acarbose, Accelerated growth, Acetazolamide, Acetic acid injection, Acetohexamide, Acid-base balance, Acne, Acrochorda, Acromegaly, Acroosteolysis, ACTH, ACTH stimulation, Activated partial thromboplastin time, Acute adrenocortical insufficiency, Acute stress reaction, Acyl-ghrelin, Adalimumab, Addison's disease, Addisonian crisis, Adenocarcinoma, ADHD, Adhesiolysis, Adiponectin, Adipose tissue, Adolescent/young adult, Adrenal, Adrenal antibodies, Adrenal function, Adrenal insufficiency, Adrenal salt-wasting crisis, Adrenal scintigraphy, Adrenal venous sampling, Adrenalectomy, Adrenaline, Adrenarche, Adrenocortical adenoma, Adrenocortical carcinoma, Adrenoleukodystrophy, Adult, Adverse breast development, Afghanistan, AFP tumour marker, Aggression, Agitation, Agnosia, AIP gene mutation, AIP gene variant, Akathisia, Akinesia, Aland Islands, Alanine aminotransferase, Albania, Albiglutide, Albumin, Albumin to creatinine ratio, Albuminuria, Alcohol intolerance, Aldosterone, Aldosterone (24-hour urine), Aldosterone (blood), Aldosterone (plasma), Aldosterone (serum), Aldosterone to renin ratio, Alendronate, Alexia, Algeria, Alkaline phosphatase, Alkaline phosphatase (bone-specific), Alogliptin, Alopecia, Alpha-blockers, Alpha-fetoprotein, Alpha-glucosidase inhibitors, Alphacalcidol, Altered level of consciousness, Amaurosis, Amaurosis fugax, Ambiguous genitalia, Amblyopia, Amenorrhoea, Amenorrhoea (primary), Amenorrhoea (secondary), American Indian or Alaska Native, American Samoa, Ameurosis, AMH, Amiloride, Amlodipine, Ammonia, Amnesia, Amniocentesis, Amoxicillin, Amputation, Amusia, Amylase, Amyloid goitre, Amyloidosis, Anaemia, Analgesics, Anaplastic thyroid cancer, Anasarca, Anastrozole, Andorra, Androgen insensitivity syndrome, Androgens, Andrology, Androstenedione, Androsterone, Aneuploidy, Angiography, Angiomyxoma, Angioplasty, Angiotensin, Angiotensin receptor antagonists, Angiotensin-converting enzyme inhibitors, Angola, Anguilla, Anhedonia, Anion gap, Anisocoria, Ankle swelling, Anorchia, Anorectal malformations, Anorexia, Anosmia, Anosognosia, Anovulation, Antarctica, Antepartum haemorrhage, Anthracyclines, Anti-acetylcholine antibodies, Anti-GH antibodies, Anti-insulin antibodies, Anti-islet cell antibody, Anti-phospholipid antibody syndrome, Anti-tyrosine phosphatase antibodies, Antiandrogens, Antibiotics, Anticardiolipin antibody, Antidiuretic Hormone, Antiemetics, Antiepileptics, Antigua and Barbuda, Antinuclear antibody, Antipsychotics, Antiseptic, Antithyroid drugs, Antivirals, Anuria, Anxiety, Apathy, Aphasia, Aphonia, Apnoea, Apolipoprotein H, Appendicitis, Appetite increase, Appetite reduction/loss, Apraxia, Aqueductal stenosis, Argentina, Aripiprazole, Armenia, Aromatase inhibitors, Arteriosclerosis, Arthralgia, Arthrodesis, Articulation impairment, Aruba, Ascites, Asian - 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thick, Toes - widely spaced, Tofogliflozin, Togo, Tokelau, Tolazamide, Tolbutamide, Tolvaptan, Tonga, Tongue - protruding, Total cholesterol, Total ghrelin, Trabecular thickness, Tracheo-oesophageal compression, Tracheo-oesophageal fistula, Tracheostomy, Tramadol, Transaminase, Transcranial surgery, Transsphenoidal surgery, Transtentorial surgery, Transvaginal ultrasound, TRAP 5b, Trastuzumab, Traumatic brain injury, Trazodone, Tremulousness, TRH, TRH stimulation, Triamcinolone, Triamterene, Tricuspid insufficiency, Triglycerides, Trimipramine, Trinidad and Tobago, Troglitazone, Troponin, Tryptophan, TSH, TSH receptor antibodies, Tuberculosis, Tuberous sclerosis complex, Tumour-induced osteomalacia, Tumours and neoplasia, Tunisia, Turkey, Turkmenistan, Turks and Caicos Islands, Turner syndrome, Turosteride, Tuvalu, Type 3 precollagen, Type 4 collagen, Tyrosine-kinase inhibitors, Uganda, Ukraine, Ultrasound scan, Ultrasound-guided biopsy, Umbilical hernia, Unilateral adrenal hyperplasia, Unique/Unexpected Symptoms or Presentations of a Disease, United Arab Emirates, United Kingdom, United States, United States Minor Outlying Islands, Unusual Effects of Medical Treatment, Uraemia, Urea and electrolytes, Ureter duplex, Ureterolithiasis, Uric acid (blood), Uric acid (urine), Uricaemia, Urinalysis, Urinary free cortisol, Urinary frequency, Urinary incontinence, Urine 24-hour volume, Urine osmolality, Urogenital sinus, Urolithiasis, Urology, Urticaria, Uruguay, Uterine hyperplasia, Uterus duplex, Uzbekistan, Vagina duplex, Vaginal bleeding, Vaginal discharge, Vaginal dryness, Vaginal examination, Vaginal pain/tenderness, Vaginism, Vaginoplasty, Vagotomy, Valproic acid, Valrubicin, Vandetanib, Vanillylmandelic acid (24-hour urine), Vanuatu, Vaptans, Vatican City State, Venezuela, Ventricular fibrillation, Ventricular hypertrophy, Vertigo, Viet Nam, Vildagliptin, Vinorelbine, VIP, Viraemia, Virgin Islands, British, Virgin Islands, U.S, Virilisation (abnormal), Vision - 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