title: [Pheochromocytoma in end-stage renal disease patient treated by peritoneal dialysis].
abstract: Pheochromocytoma is a rare tumor responsible for paroxysmal hypertension which is difficult to control. Diagnosis is important because it represents a curable form of hypertension. Few cases of pheochromocytoma patients with end-stage renal failure were reported in the literature. These cases are specially responsible for diagnosis and therapeutic problems. We report here a case of an end-stage renal failure patient who has pheochromocytoma, he was treated by automated peritoneal dialysis. The patient is a 47-year-old man who has an IgA glomerulonephritis. On peritoneal dialysis, his blood pressure level remains high despite four antihypertensive drugs association and adequate dialysis. Furthermore, the patient suffered from headaches, sweats and palpitations. This leads to suspect pheochromocytoma. Thus, urinary excretion rates of metanephrines and normetanephrines were high. Radiographic diagnosis tests were negative but MIBG scintigraphy was able to localise the tumor in the left suprarenal gland. He had coelioscopic left adrenalectomy without complications, microscopic studies showed an hyperplasia of the adrenal medulla. Soon after surgery his blood pressure was well controlled by one antihypertensive drug. We conclude that refractory hypertension, as a possible diagnosis, is uncommon in peritoneal dialysis patients. Pheochromocytoma must be eliminated by careful evaluation.
authors.affiliation: Service de néphrologie et de médecine interne A, hôpital Charles-Nicolle, boulevard 9-Avril, BS 1006, Tunis, Tunisie.
authors.forename: Imen
authors.initials: I
authors.lastname: Gorsane
authors.forename: Karim
authors.initials: K
authors.lastname: Zouaghi
authors.forename: Rim
authors.initials: R
authors.lastname: Goucha
authors.forename: Mohamed Mongi
authors.initials: MM
authors.lastname: Bacha
authors.forename: Hafedh
authors.initials: H
authors.lastname: Hedri
authors.forename: Karima
authors.initials: K
authors.lastname: Khiari
authors.forename: Ezzedine
authors.initials: E
authors.lastname: Abderrahim
authors.forename: Taieb Ben
authors.initials: TB
authors.lastname: Abdallah
authors.forename: Nejib Ben
authors.initials: NB
authors.lastname: Abdallah
authors.forename: Fatma Ben
authors.initials: FB
authors.lastname: Moussa
authors.forename: Hedi Ben
authors.initials: HB
authors.lastname: Maiz
authors.forename: Adel
authors.initials: A
authors.lastname: Kheder
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000175:diagnosis* / Q000601:surgery; D000315:Adrenalectomy; D000328:Adult; D005260:Female; D006261:Headache / Q000209:etiology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy*; D008297:Male; D008676:Metanephrine / Q000652:urine; D008875:Middle Aged; D009393:Nephritis / Q000150:complications* / Q000628:therapy; D009647:Normetanephrine / Q000652:urine; D010530:Peritoneal Dialysis; D010673:Pheochromocytoma / Q000175:diagnosis* / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D009647:Normetanephrine; D008676:Metanephrine