The condition is called Latin.pheochromocytomait is quite rare, because it occurs in 0.5-1.0%. people with hypertension. It consists in the reproduction of specific cells that produce uncontrolledly two substances regulating the pressure - noradrenaline and adrenaline. The generous production of adrenaline causes, among others rapid increase in blood pressure.
What are the symptoms of pheochromocytoma?
The disease symptoms caused by the pheochromocytoma may be different. Symptoms are usually paroxysmal, which is associated with periodic burst of hormones by the tumor. During an attack, there is a surge in blood pressure accompanied by sweat, trembling fingers, strong heart beat, anxiety and pallor. Symptoms can be very severe or moderate.
How do we verify symptoms that indicate pheochromocytoma?
With typical symptoms, the diagnosis of the tumor is not difficult. It is necessary to determine in the daily collection of urine the amount of mandelic and vanillylmandelic acid - adrenaline and norepinephrine metabolites and imaging, first of all ultrasound (USG) of the abdominal cavity, with particular attention to the adrenal glands. If the lesion can not be seen in the ultrasound, it is necessary to perform a scintigraphic examination using a marker that accumulates in the pheochromocytoma cells from which the adrenal medullary tumors and other parts of the sympathetic system are built. A test with a marker is of particular importance when the core tumor is small. In further refinement of the diagnosis, computed tomography and magnetic resonance are used.
Does an untreated disease-inducing tumor endanger diabetic complications?
Pheochromocytoma and diabetes - this is one of the pathological connections initiating diabetes. Excess adrenaline and norepinephrine leads to glucose metabolism disorders. Hormones inhibit insulin production, exacerbate the breakdown of glycogen in the liver, increase hepatic glucose production and reduce tissue glucose consumption. These metabolic changes cause that adrenal medulla tumors in 40%. cases are accompanied by latent or overt diabetes. Sometimes it requires the use of insulin. Removal of the tumor usually leads to its resolution.
What else threatens an unrecognized disease?
In patients with a long-established tumor, secondary complications occur in the cardiovascular system and other organs associated with hypertension and metabolic disorders. That is why it is very important to quickly recognize and apply treatment. Treatment consists of a tumor resection procedure - after preparing the patient with appropriate medications for surgery.
Where is the tumor located?
Usually the location of the pheochromocytoma are adrenal glands - small glands located above the kidneys that produce important hormones for life. (Corticosteroids, arising in the cortex - the outer part of the adrenal gland, and the adrenaline and norepinephrine already mentioned, produced by the core - the inner part of the gland.) Sometimes adrenaline and noradrenaline cells can locate in other parts of the body, especially the abdominal cavity.
How is the patient getting ready for surgery?
Before surgery, it is necessary to administer alpha and beta blocking agents. Without proper preparation of such drugs, the procedure can not be performed, because during surgery sometimes large amounts of hormones are removed from the tumor being removed. Blocking the receptors affected by adrenaline and norepinephrine prevents serious complications caused by a sharp rise in blood pressure.
Final remarks:
Rapid diagnosis and subsequent surgical removal of the pheochromocytoma usually leads to full recovery and prevents the occurrence of life-threatening complications.
Ed. Edward Ozga Michalski, MA
Consultation by prof. dr hab. med. Andrzej Danysz
