title: A case of pheochromocytoma presenting as secondary hyperaldosteronism, hyperparathyroidism, diabetes and proteinuric renal disease.
abstract: A 35-year-old woman was admitted to the Nephrology and Dialysis Unit of Pisa University for hypertension, hypokalaemia, renal impairment, proteinuria and hyperglycaemia. plasma renin activity (PRA) and plasma aldosterone were elevated, but Doppler ultrasound and angio-computed tomography (CT) of renal arteries were normal. Abdomen CT revealed only a left adrenal mass, and measurement of catecholamines suggested the diagnosis of pheochromocytoma. Biochemical findings suggestive of hyperparathyroidism were also detected, but a multiple endocrine disorder was excluded by genetic analysis. Pathology examination confirmed the pheochromocytoma and immunohistochemistry also showed positivity for parathyroid hormone. After surgery, disappearance of the symptoms and normalization of all haemodynamic and humoral parameters was observed. This is a rare case of pheochromocytoma responsible for secondary hyperaldosteronism, hyperparathyroidism, proteinuric renal disease and diabetes mellitus.
authors.affiliation: Department of Renal Unit of Internal Medicine, Hachioji Medical Center of Tokyo Medical University, 1163 Tate-machi, Hachioji-shi, Tokyo 193-0998, Japan. g.bernini@med.unipi.it
authors.forename: Matteo
authors.initials: M
authors.lastname: Bernini
authors.forename: Alessandra
authors.initials: A
authors.lastname: Bacca
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Casto
authors.forename: Valentina
authors.initials: V
authors.lastname: Carli
authors.forename: Adamasco
authors.initials: A
authors.lastname: Cupisti
authors.forename: Davide
authors.initials: D
authors.lastname: Carrara
authors.forename: Ilaria
authors.initials: I
authors.lastname: Farnesi
authors.forename: Giuliano
authors.initials: G
authors.lastname: Barsotti
authors.forename: Antonio Giuseppe
authors.initials: AG
authors.lastname: Naccarato
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Bernini
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000150:complications* / Q000175:diagnosis; D000328:Adult; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006961:Hyperparathyroidism / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006973:Hypertension / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D007674:Kidney Diseases / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D010673:Pheochromocytoma / Q000150:complications* / Q000175:diagnosis; D011379:Prognosis; D011507:Proteinuria / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery