Long-term efficacy of doxazosin plus atenolol in the management of severe and sustained arterial hypertension and reversibility of the cardiac damage induced by chronic cathecolamine excess. A case report in a young girl with recurrent, functioning paraganglioma.
Herein we report on a young girl with recurrent, functioning paraganglioma of the organ of Zuckerkandl and severe and sustained arterial hypertension (systolic pressure >200, diastolic pressure >120 mmHg); with evidence of cardiac damage induced by chronic cathecolamine excess. She promptly and steadily improved after the institution of doxazosin (6 mg/day) plus atenolol (50 mg bid) treatment. This case demonstrates that a correct therapeutic strategy in the long-term management of patients with inoperable catecholamine-producing neuroendocrine tumors (pheochromocytomas and paragangliomas) can maintain arterial pressure in the normal range and reverse the cardiac damage induced by chronic cathecolamine excess.
Pulcrano
M
M
Department of Clinical and Molecular Endocrinology and Oncology, Federico II University School of Medicine, Naples, Italy.
Palmieri
E A
EA
Pagano
L
L
Tauchmanova
L
L
Rossi
A
A
Fazio
S
S
Lombardi
G
G
Biondi
B
B
D019797:3-Iodobenzylguanidine; D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use*; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D001262:Atenolol / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D002395:Catecholamines / Q000097:blood / Q000502:physiology*; D002648:Child; D017292:Doxazosin / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004562:Electrocardiography / Q000187:drug effects; D005260:Female; D006331:Heart Diseases / Q000188:drug therapy* / Q000473:pathology; D006338:Heart Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D017379:Hypertrophy, Left Ventricular / Q000188:drug therapy / Q000473:pathology; D010220:Para-Aortic Bodies / Q000000981:diagnostic imaging*; D010235:Paraganglioma / Q000150:complications* / Q000000981:diagnostic imaging; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals
D000317:Adrenergic alpha-Antagonists; D000319:Adrenergic beta-Antagonists; D002395:Catecholamines; D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine; D001262:Atenolol; D017292:Doxazosin