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[Pheochromocytoma in end-stage renal disease patient treated by peritoneal dialysis].

Abstract
Pheochromocytoma is a rare tumor responsible for paroxysmal hypertension which is difficult to control. Diagnosis is important because it represents a curable form of hypertension. Few cases of pheochromocytoma patients with end-stage renal failure were reported in the literature. These cases are specially responsible for diagnosis and therapeutic problems. We report here a case of an end-stage renal failure patient who has pheochromocytoma, he was treated by automated peritoneal dialysis. The patient is a 47-year-old man who has an IgA glomerulonephritis. On peritoneal dialysis, his blood pressure level remains high despite four antihypertensive drugs association and adequate dialysis. Furthermore, the patient suffered from headaches, sweats and palpitations. This leads to suspect pheochromocytoma. Thus, urinary excretion rates of metanephrines and normetanephrines were high. Radiographic diagnosis tests were negative but MIBG scintigraphy was able to localise the tumor in the left suprarenal gland. He had coelioscopic left adrenalectomy without complications, microscopic studies showed an hyperplasia of the adrenal medulla. Soon after surgery his blood pressure was well controlled by one antihypertensive drug. We conclude that refractory hypertension, as a possible diagnosis, is uncommon in peritoneal dialysis patients. Pheochromocytoma must be eliminated by careful evaluation.
AuthorsImen Gorsane, Karim Zouaghi, Rim Goucha, Mohamed Mongi Bacha, Hafedh Hedri, Karima Khiari, Ezzedine Abderrahim, Taieb Ben Abdallah, Nejib Ben Abdallah, Fatma Ben Moussa, Hedi Ben Maiz, Adel Kheder
JournalNephrologie & therapeutique (Nephrol Ther) Vol. 4 Issue 7 Pg. 597-601 (Dec 2008) ISSN: 1769-7255 [Print] France
Vernacular TitlePhéochromocytome surrénalien chez un insuffisant rénal chronique en dialyse péritonéale.
PMID18674976 (Publication Type: Case Reports, English Abstract, Journal Article)
Chemical References
  • Normetanephrine
  • Metanephrine
Topics
  • Adrenal Gland Neoplasms (diagnosis, surgery)
  • Adrenalectomy
  • Adult
  • Female
  • Headache (etiology)
  • Humans
  • Kidney Failure, Chronic (complications, therapy)
  • Male
  • Metanephrine (urine)
  • Middle Aged
  • Nephritis (complications, therapy)
  • Normetanephrine (urine)
  • Peritoneal Dialysis
  • Pheochromocytoma (diagnosis, surgery)
  • Treatment Outcome

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