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Suggest treatment for persistent high fevers with racing hearts

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Endocrinologist
Practicing since : 2001
Answered : 1663 Questions
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My friend has been having persistent high fevers for the last six months and in this time, rarely has she been within normal range. She has seen an Internal Specialist, Lung Specialist, Neurologist, Cardiologist and had an MRI, Pet Scan and other tests and blood tests. The only test she is awaiting the results is the 24 hour urine test to check something in relation to her adrenal glands I think. She is very tired, gets dizzy, has a racing heart rate at times, her blood pressure can drop upon standing (I think)
Posted Mon, 25 Aug 2014 in Thyroid Problem and Hormonal Problems
 
 
Answered by Dr. Shehzad Topiwala 37 minutes later
Brief Answer:
Adrenal

Detailed Answer:
Sorry to learn about your friend's medical condition.

Some of the symptoms you have described do suggest the possibility of a rare adrenal problem called Pheochromocytoma. It is typically a benign tumor that produces excess of 'adrenaline-type' hormones that result in various symptoms such as : heart racing, blood pressure fluctuations and episodes of sweating/chest pain/shortness of breath.

The test that is most likely been ordered for your friend is a 24 hour urinary fractionated catecholamines and metanephrines.

Some medications may interfere with this test and I am sure the treating doctors are aware of this.

An endocrinologist is best equipped to manage this condition.

I would also like to believe that as part of the comprehensive testing your friend has underwent, the following tests have also already been performed and found to be essentially normal:

TSH
Complete Blood Count
Electrolytes
Calcium
Creatinine
Liver function tests
Glucose

And if there is a reason to suspect adrenal insufficiency, then there is a blood test called serum cortisol that needs to be done at 8 am in the morning
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