Extraadrenal Pheochromocytoma With Renal Artery “Pseudostenosis”—An Important Pitfall

Extra-adrenal Pheochromocytoma Associated With Segmental Renal Artery Compression and Pseudostenosis

Renal artery stenosis and pheochromocytoma: Coexistence and treatment

Endocrine hypertension traditionally associates with conditions leading to activation of either mineralocorticoid, glucocorticoid, or adrenergic receptors. These conditions include primary aldosteronism and some forms of congenital adrenal hyperplasia, Cushing’s, and pheochromocytoma/paraganglioma syndromes, respectively. One needs to remember that these conditions are rare, but associate with significant morbidity and need to be included in the differential diagnosis of “unusual” hypertension, such as treatment resistant, episodic, rapidly progressive forms, or hypertension of the young. Biochemical proof of existing hormonal excess may be hard at times, because of low volume of hormonal hypersecretion and episodic secretion or dynamic change in the secretory profile which may be related to the tumor differentiation status. Coexisting chronic renal disease tremendously complicates biochemical diagnosis on multiple levels, including change in the hormonal milieu directly related to renal failure, and change of systemic hormones levels related to both intrinsic metabolic rate as well as renal excretion. Normal cutoff levels are not well established for different degrees of reduced glomerular filtration rate, while renal ability to excrete water and electrolytes can directly affect endogenous secretion of mineralocorticoids. To maximize efficacy of diagnosis of endocrine hypertension in patients with chronic renal disease, we recommend screening selected patients for primary aldosteronism, glucocorticoid excess, and pheochromocytoma/paraganglioma syndromes using recently published Endocrine Society guidelines.

Endocrine Hypertension and Chronic Kidney Disease

Chronic kidney disease and hypertension / , Chronic kidney disease and hypertension / , کتابخانه دیجیتال جندی شاپور اهواز

http://centlib.ajums.ac.ir//multiMediaFile/251311209-4-1.pdf

Chronic Kidney Disease and Hypertension

Clinical quiz. Left perirenal phaeochromocytoma and left upper pole renal artery stenosis. Combined excision of tumor and left total nephroadrenalectomy, after full alpha- and beta-adrenergic blockade was achieved.

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Clinical quiz. Left perirenal phaeochromocytoma and left upper pole renal artery stenosis. Combined excision of tumor and left total nephroadrenalectomy, after full alpha- and beta-adrenergic blockade was achieved.