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BP 180/156, Pulse 148, Jerking, Anxiety, Taken Sectral, Celexa. Pheochromocytoma?

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Posted on Tue, 22 May 2012
Question: Hi, I have been having night time episodes of the feeling of icy hot running through my veins and bp shot up to 180/156 with a pulse of 148 in my sleep. Woke up called 911. Once we reached the hospital I began jerking like I had parkinsons uncontrollably. After a month on a heart event monitor I was told my heart was fine. I was diagnosed with anxiety and given sectral and celexa. When the pills did not fix the episodes (except the bp is good now) I was given a 24 hour urine test which came back high for catecholomines (sorry prob. spelled that wrong). Now I am waiting to get in and see an endocrinologist. My question is can a person with a pheochromocytoma only have symptoms at night or in their sleep?
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Answered by Dr. Jasvinder Singh (22 minutes later)
Hello XXXXXXX

Thanks for posting your query. It is not necessary that patients of pheochromocytoma have symptoms like hot flushes, increased BP and fast pulse (tachycardia) only at night. These symptoms can occur at any time during the day and most of the patients have the symptoms randomly. Most common symptoms of pheochromocytoma apart from the ones you had are palpitations, headache, pallor, weight loss and elevated blood glucose levels.

You have got high catecholamines in urine but apart from pheochromocytoma these can be found in high levels of stress and anxiety also. So apart from 24 hours of urinary levels of catecholamines, you need metanephrine levels in blood also. If they come positive then imaging studies are usually done to look at the adrenal glands.

This is done by CT scan, T2 weighted MRI of the head, neck, chest, and abdomen and using an MIBG scan, which is scintigraphy using iodine-123-marked metaiodobenzylguanidine. Please discuss these diagnostic tests with your endocrinologist when you XXXXXXX him this week.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.

Regards.

Note: For further queries related to kidney problems Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Jasvinder Singh

Internal Medicine Specialist

Practicing since :1998

Answered : 1578 Questions

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BP 180/156, Pulse 148, Jerking, Anxiety, Taken Sectral, Celexa. Pheochromocytoma?

Hello XXXXXXX

Thanks for posting your query. It is not necessary that patients of pheochromocytoma have symptoms like hot flushes, increased BP and fast pulse (tachycardia) only at night. These symptoms can occur at any time during the day and most of the patients have the symptoms randomly. Most common symptoms of pheochromocytoma apart from the ones you had are palpitations, headache, pallor, weight loss and elevated blood glucose levels.

You have got high catecholamines in urine but apart from pheochromocytoma these can be found in high levels of stress and anxiety also. So apart from 24 hours of urinary levels of catecholamines, you need metanephrine levels in blood also. If they come positive then imaging studies are usually done to look at the adrenal glands.

This is done by CT scan, T2 weighted MRI of the head, neck, chest, and abdomen and using an MIBG scan, which is scintigraphy using iodine-123-marked metaiodobenzylguanidine. Please discuss these diagnostic tests with your endocrinologist when you XXXXXXX him this week.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.

Regards.