A pheochromocytoma on steroids

Warren, Christopher J.; Jardine, David L.; Cawood, Thomas James

doi:10.1007/s10286-019-00638-4

Cited by 2 publications

(1 citation statement)

References 5 publications

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“…The reverse has also been reported: patients with severe orthostatic hypotension and hypertension believed to have baroreflex failure and found to have a pheochromocytoma instead. 30 Afferent baroreceptor lesions seldom occur in isolation. The majority of patients will have additional signs of cranial nerve deficits, including vocal cord palsy, dysphagia, facial drop, gaze palsy, deafness, or dysphonia/hypophonia (►Table 1).…”

Section: Clinical Picturementioning

confidence: 99%

Afferent Baroreflex Dysfunction: Decreased or Excessive Signaling Results in Distinct Phenotypes

2020

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Head and neck tumors can affect afferent baroreceptor neurons and either interrupt or intermittently increase their signaling, causing blood pressure to become erratic. When the afferent fibers of the baroreflex are injured by surgery or radiotherapy or fail to develop as in familial dysautonomia, their sensory information is no longer present to regulate arterial blood pressure, resulting in afferent baroreflex failure. When the baroreflex afferents are abnormally activated, such as by paragangliomas in the neck, presumably by direct compression, they trigger acute hypotension and bradycardia and frequently syncope, by a mechanism similar to the carotid sinus syndrome. We describe our observations in a large series of 23 patients with afferent baroreflex dysfunction and the cardiovascular autonomic features that arise when the sensory baroreceptor neurons are injured or compressed. The management of afferent baroreceptor dysfunction is limited, but pharmacological strategies can mitigate blood pressure swings, improve symptoms, and may reduce hypertensive organ damage. Although rare, the prevalence of afferent baroreflex dysfunction appears to be increasing in middle-aged men due to human papillomavirus related oropharyngeal cancer.

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Section: Clinical Picturementioning

confidence: 99%