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Can chronic headache cause malignant HTN and CKD 3? - Online Doctor Chats

Date : 25-Mar-2014
User rating for this question
Very Good Posted in: Cancer
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2568 Questions
Thank you for your time. I am wf 47 married professional . I have been dx'd w Pheochromocytoma , Scleroderma, Raynauds, Sjogrens, Eso Stenosis ( CREST Syndrome), RA and have a hx of CIN V with XXXXXXX and BSO. The issue is finding the pheochromocytoma and having it removed if possible. I have had CTs, PET scan, octreocide (sp?) and multiple MRIs including an experimental Tesla 3, without result. I have developed a chronic headache always on the left frontal or temporal areas, their is nausea usually without vomiting, light sensitivity and just a general sense of feeling like crap. I saw a neurologist who suggested that the headaches were causing pain which in turn is causing malig HTN w CKD III . Um, not sure this makes sense , since the headaches have started approximately four years after a urine catacholamine result greater than 5k times normal, which is highly suggestive of pheochromocytoma.

I searching for any suggestions or answers, this is greatly impacting my once very happy and active life. I do not smoke or drink and I am not obese.

Thank you! XXXXXXX
Let me read your query for few minutes to be able to have a good discussion here.
User:Thank you
Doctor:Your condition is very difficult
User:Yes, I'm quite aware. Some physicians won't even see me
Doctor:I have gone through your question and I see that you have undergone all the investigations that we normally advice patients with pheochromacytoma
Doctor:But I would disagree with your neorologist on one thing,
User:Any suggestions ?
Doctor:that is I think your, pheochromacytoma is the reason for malignant HTN and also headaches and not the other way around
Doctor:Only suggestion is... Go for partial adrenalectomy
Doctor:PET scans should be able to show the location of the tumor, if they are not, then you should ask them to do 1mm slices on the PET scan, that would pin point the location of the tumor
Doctor:Other imaging option is Magnetic resonance angiogram
Doctor:One thing also to keep in mind is to look for these tumors elsewhere
Doctor:that is sites other than the adrenal gland itself
User:Even if the pheochromocytoma is not located on one of the adrenals? Exploratory vein mapping was offered, but I think the anes risk is too great as I have had problems with past surg/ anes. What about hypothyroidism? And the meds I take, could they be causing the headache . Metoprolol 100 mg bid. Doxazosin 2mg bid and Labetalol 300 mg bid
Doctor:I don't think these medicines are causing the headaches
Doctor:You don't have to go for exploratory vein mapping, instead you can go for selective adrenal angiogram
Doctor:Pheochromacytomas are highly vascular, so that will be an indirect way of detecting the tumor
Doctor:once it is proven that way, a fine needle aspiration cytology can be performed to confirm if it is really the actual tumor
Doctor:if proven, you can go ahead with the surgical removal of the tumor
User:I agree the meds are not doing it. I will make these suggestions to my endo next week. Unfortunately, I live in a small Alabama town, we just got an allergist last year. Would you recommend Emory or University of Ala at Birmingham.
Doctor:Both are exceptionally renowned tertiary care teaching hospitals
Doctor:You can choose whichever you are comfortable with
Doctor:Is there anything else I can help you with?
Doctor:You can go to University of Alabama Birmingham
User:Thank you for your help and suggestions. I am very grateful. Have a healthy day.
Doctor:You are most welcome
Doctor:Thank you for using our services
Doctor:take care
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