New Insights Into Pseudopheochromocytoma and Emotionally Provoked Hypertension

Küchel, Otto

doi:10.1007/978-1-59259-757-4_15

“…These episodes should be differentiated from pseudopheochromocytoma, which refers to the large majority of individuals (often women) with severe paroxysmal hypertension, whether normotensive or hypertensive between episodes, (Kuchel, 1985), related to a short-term activation of the sympathetic nervous system. In contrast to pheochromocytoma, patients with pseudopheochromocytoma more often present with panic attacks or anxiety, flushing, nausea and polyuria (Kuchel, 1985, 2004; White and Baker, 1986). …”

Section: Presentmentioning

confidence: 99%

Pheochromocytoma and Paraganglioma

Kantorovich

¹

,

Pacák

²

2010

Neuroendocrinology - Pathological Situations and Diseases

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Pheochromocytoma is a very special kind of tumor full of duplicity. On the one hand it represents its own microworld with unique clinical, biochemical and pathological features, while on the other it constitutes a tremendously significant part of whole body system, playing a vital role for practically every organ system. It has a very special character – sometimes like a child it can be sweet and predictable, while at times it can behave like a deadly wild beast, crashing and tearing everything on its path in a fierce rage. It also consists of the amazingly intelligent neuroendocrine cells that possess a magical ability to make miraculous substances of many kinds. But most of all, it is a system that is able to drive our curiosity and the itch of “Cogito, ergo sum” to limitless depths and year by year it still amazes us with new and unexpected discoveries that move our understanding of multiple pathways and metabolic events closer to the ultimate truth. Recent discoveries of succinate dehydrogenase (SHD) and prolyl hydroxylase (PHD) mutations, for example, propelled our understanding of neuroendocrine tumorigenesis as a whole, as well as physiology of mitochondrial respiratory chain and phenomenon of pseudohypoxia in particular. Good old discoveries make their way from dusty repositories to shine with new meaning, appropriate for the current level of knowledge. This acquired wisdom makes us better physicians – knowing the specific expression makeup of catecholamine transporters, GLUTs and SRIFs allows for better tailored imaging and therapeutic manipulations. There are still long ways to go, keeping in mind that pheochromocytoma is but so very special, and we are optimistic and expect many great things to come.

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“…These episodes should be differentiated from pseudopheochromocytoma, which refers to the large majority of individuals (often women) with severe paroxysmal hypertension, whether normotensive or hypertensive between episodes, (Kuchel, 1985), related to a short-term activation of the sympathetic nervous system. In contrast to pheochromocytoma, patients with pseudopheochromocytoma more often present with panic attacks or anxiety, flushing, nausea and polyuria (Kuchel, 1985(Kuchel, , 2004White and Baker, 1986).…”

Section: Clinical Presentationmentioning

confidence: 99%

“…These episodes should be differentiated from pseudopheochromocytoma, which refers to the large majority of individuals (often women) with severe paroxysmal hypertension, whether normotensive or hypertensive between episodes, (Kuchel, 1985), related to a short-term activation of the sympathetic nervous system. In contrast to pheochromocytoma, patients with pseudopheochromocytoma more often present with panic attacks or anxiety, flushing, nausea and polyuria (Kuchel, 1985(Kuchel, , 2004White and Baker, 1986).Less common clinical manifestations include fever of unknown origin (hypermetabolic state) and constipation secondary to catecholamine-induced decrease in intestinal motility (Bouloux and Fakeeh, 1995). Observed flushing is rare, but can follow the vasoconstrictive episode of pallor or Raynaud's phenomenon, associated with the attack (Manger and Gifford, 1996).…”

mentioning

confidence: 99%

Pheochromocytoma and Paraganglioma

Pacák

¹

,

Wimalawansa

²

2015

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“…The term pseudopheochromocytoma, used to describe paroxysmal hypertension that occurs in the absence of a pheochromocytoma, is of historical interest because it represented the first serious attempt to describe the syndrome. Dr Otto Kuchel, who worked with Jacques Genest in Montreal, popularized the concept in the 1980s 1,2 . He described a series of 7480 hypertensive patients referred in Montreal for evaluation, of whom there were 8 who turned out to have a pheochromocytoma, but 688 who had paroxysmal or intermittent hypertension.…”

Section: Pseudopheochromocytomamentioning

confidence: 99%

“…In contrast, pheochromocytoma attacks may be quite spontaneous. Measurements of plasma catecholamines showed that plasma levels of free norepinephrine and epinephrine were increased in some patients because of defective inactivation by conjugation, but there was a characteristic increase of plasma dopamine 2 . Kuchel suggested that this increase of dopamine explained some of the symptoms that distinguished the condition from pheochromocytoma, such as flushing, anxiety, nausea, and polyuria.…”

Section: Pseudopheochromocytomamentioning

confidence: 99%

Paroxysmal Hypertension: The Role of Stress and Psychological Factors

Pickering

¹

,

Clemow

²

2008

J of Clinical Hypertension

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who is studied for a pheochromocytoma with negative results. for every patient referred for a suspected pheochromocytoma, there are many more who have the symptoms but do not have a tumor. although all practicing hypertension specialists must see large numbers of patients with paroxysmal hypertension, the hypertension literature is largely silent on the issue, except for discussion of pheochromocytoma. it is likely that stress and emotion play a major role in many of these cases, but physicians who treat hypertension are often unfamiliar with the underlying problems and are poorly equipped to deal with them. there is a variety of diagnostic labels given to these patients, which include pseudopheochromocytoma, panic attacks, and hyperventilation syndrome. the purpose of this paper is to review the clinical features, pathology, diagnosis, and treatment of these syndromes.an example of a patient who fulfilled these criteria and who was recently seen in our practice is described below. CASE REPORTthe patient was an 85-year-old white woman referred for evaluation of paroxysmal hypertension. she had a history of mild hypertension and hyperlipidemia of many years, which had until recently been controlled with a thiazide diuretic and a statin. she was well until January 2007, when she was found to have hyponatremia on a blood test. she was hospitalized, and the diuretic was discontinued and replaced with a calcium channel blocker. at this time, she began to have episodes of paroxysmal hypertension, which she described as starting with epigastric pain, flushing in her face, weakness, light-headedness, and a feeling of warmth and anxiety. her blood pressure was typically high during these episodes and could R e v i e w P a p e r

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New Insights Into Pseudopheochromocytoma and Emotionally Provoked Hypertension

Cited by 8 publications

References 69 publications

Pheochromocytoma and Paraganglioma

Pheochromocytoma and Paraganglioma

Pheochromocytoma and Paraganglioma

Paroxysmal Hypertension: The Role of Stress and Psychological Factors

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