Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Someone with a pheochromocytoma usually has three classic symptoms --
headache,
sweating, and heart palpitations (a fast heart beat) in association with
markedly elevated blood pressure (hypertension). Other conditions that may
accompany these classic symptoms are as follows: anxiety, nausea, tremors,
weakness, abdominal pain, and weight loss.
Some people, however, never develop symptoms of a pheochromocytoma. Up to 10%
of cases are discovered incidentally, meaning that they are not suspected and
only found when the patient is undergoing diagnostic studies for other
conditions. In some cases, the high blood pressure comes and goes and may be
difficult to document. In other cases, the blood pressure is consistently
elevated and easily recorded.
Pheochromocytomas are present in only about 0.2% of all people with high
blood pressure. There are certain conditions, however, in which the diagnosis of
pheochromocytoma may rank high on the list of possibilities; they are discussed
below.
What conditions are associated with pheochromocytomas?
Pheochromocytomas can be a component of certain familial or genetic
syndromes. The most common familial condition is called multiple endocrine
neoplasia, or MEN for short. Two types of MEN -- MEN 2A and 2B -- are associated
with pheochromocytomas. Both are genetic syndromes that run in families and are
transmitted from parent to child in an autosomal dominant manner.
Pheochromocytomas are not the only tumors that occur in MEN 2A and 2B. MEN 2A
carries an increased risk of tumors of the parathyroids, glands near the thyroid
that help to regulate calcium levels in the body. And both MEN 2A and 2B elevate
the risk of thyroid cancer. In families where MEN is suspected, genetic testing can be done to
help identify family members at risk.
Pheochromocytomas are a feature of other genetic disorders, including von
Hippel-Lindau syndrome and neurofibromatosis. Both of these
disorders are associated with the development of numerous benign and malignant
tumors.
There are also many individuals who have pheochromocytomas with no known family history of them. These
cases are termed sporadic. In general, if these patients have bilateral disease
(pheochromocytomas in both adrenal glands) or are diagnosed before the age of
21, genetic screening is
recommended.
Abdominal pain is pain in the belly and can be acute or chronic. Causes include inflammation, distention of an organ, and loss of the blood supply to an organ. Abdominal pain can reflect a major problem with one of the organs in the abdomen such as the appendix, gallbladder, large and small intestine, pancreas, liver, colon, duodenum, and spleen.
Night sweats are severe hot flashes that occur at night and result in a drenching sweat. In order to distinguish night sweats that arise from medical causes from those that occur because one's surroundings are too warm, doctors generally refer to true night sweats as severe hot flashes occurring at night that can drench sleepwear and sheets, which are not related to an overheated environment.
High blood pressure, also known as hypertension, is a repeatedly
elevated blood pressure exceeding 140 over 90 mmHg -- a systolic pressure above
140 with a diastolic pressure above 90. There are two causes of high blood pressure, primary and secondary. Primary high blood pressure is much more common that secondary and its basic causes or underlying defects are not always known. It is known that a diet high in salt increases the risk for high blood pressure, as well as high cholesterol. Genetic factors are also a primary cause. Secondary high blood pressure is generally caused by another condition such as renal hypertension, tumors, and other conditions. Treatment for high blood pressure is generally lifestyle changes and if necessary, diet.
Anxiety is a feeling of apprehension and fear characterized by physical symptoms. Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults.
Headaches can be divided into two categories: primary headaches and secondary headaches. Migraine headaches, tension headaches, and cluster headaches are considered primary headaches. Secondary headaches are caused by disease. Headache symptoms vary with the headache type. Over-the-counter pain relievers provide short-term relief for most headaches.
There are four major types of thyroid cancer: papillary, follicular, medullary, and anaplastic thyroid cancer. Tumors on the thyroid are referred to as thyroid nodules. Symptoms of thyroid cancer include swollen lymph nodes, pain in the throat, difficulty swallowing, hoarseness, and a lump near the Adam's apple. Treatment usually involves chemotherapy, surgery, radioactive iodine, hormone treatment or external radiation and depends upon the type of thyroid cancer, the patient's age, the tumor size, and whether the cancer has metastasized.
Nausea is an uneasiness of the stomach that often precedes vomiting. Nausea and vomiting are not diseases, but they are symptoms of many conditions. The causes of vomiting differ according to age, and treatment depends upon the cause of nausea and vomiting.
Palpitations are unpleasant sensations of irregular and/or forceful beating of the heart. Palpitations can be relieved in many patients by stress reduction, stopping cigarettes, and reduction of caffeine and alcohol.
Tremor is the involuntary movements of one or more parts of the body. Causes of tremor include neurological disorders, neurodegenerative diseases, drugs, mercury poisoning, overactive thyroid and liver failure. There are several types of tremor. Treatment depends upon the type of tremor and availability of medications for the condition.
Genetic disease is a disorder or condition caused by abnormalities in a person's genome. Types of genetic inheritance include single inheritance (for example, cystic fibrosis, sickle cell anemia, Marfan syndrome, and hemochromatosis), multifactoral inheritance, chromosome abnormalities (for example, Turner syndrome, and Klinefelter syndrome), and mitochondrial inheritance (for example, epilepsy and dementia).
Your health care provider may refer you to a genetic professional. Universities and medical centers also often have affiliated genetic professionals, or can provide referrals to a genetic professional or genetics clinic. Genetic counseling provides patients and family members the tools to make the right choice in regard to test for a disease or condition.
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