title: Diagnosis of pheochromocytoma in a hemodialysis patient through measurement of plasma catecholamines.
abstract: We report the case of a patient on chronic hemodialysis treatment with paroxysms of severe arterial hypertension accompanied by tachycardia, pallor, sweating and tremor. Measurement of plasma catecholamines revealed norepinephrine level of 4625 pg/mL (reference range 191-225 pg/mL), epinephrine level of 1035 pg/mL (58-76 pg/mL) and dopamine level of 148 pg/mL (50-100 pg/mL). MRI showed a left adrenal mass of 2 cm. After the patient was started on an alpha-1 adrenergic receptor blocker, she underwent a left adrenalectomy. Anatomopathological examination confirmed the diagnosis of pheochromocytoma. Although urinary testing is not possible in anuric hemodialysis patients, diagnosis of pheochromocytoma can be made through measurement of plasma free metanephrines and/or plasma catecholamines.
authors.affiliation: Department of Internal Medicine, Ghent University Hospital, Ghent, Belgium.
authors.forename: Bram
authors.initials: B
authors.lastname: Vantomme
authors.affiliation: Department of Nephrology, St. Lucas General Hospital, Ghent, Belgium.
authors.forename: Jan
authors.initials: J
authors.lastname: Donck
authors.affiliation: Department of Nephrology, St. Lucas General Hospital, Ghent, Belgium.
authors.forename: Simon
authors.initials: S
authors.lastname: van Hooland
authors.affiliation: Department of Nephrology, St. Lucas General Hospital, Ghent, Belgium.
authors.forename: Anne
authors.initials: A
authors.lastname: Wauters
authors.affiliation: Department of Nephrology, St. Lucas General Hospital, Ghent, Belgium.
authors.forename: Marc
authors.initials: M
authors.lastname: De Clippele
authors.affiliation: Department of Nephrology, St. Lucas General Hospital, Ghent, Belgium.
authors.forename: Valerie
authors.initials: V
authors.lastname: Neirynck
authors.affiliation: Department of Endocrinology, St. Lucas General Hospital, Ghent, Belgium.
authors.forename: Frédérique
authors.initials: F
authors.lastname: Huysman
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000097:blood / Q000175:diagnosis*; D002395:Catecholamines / Q000097:blood*; D005260:Female; D006801:Humans; D008676:Metanephrine / Q000097:blood; D008875:Middle Aged; D010673:Pheochromocytoma / Q000097:blood / Q000175:diagnosis*; D006435:Renal Dialysis
chemical_list: D002395:Catecholamines; D008676:Metanephrine
keywords: Arterial hypertension; dialysis; end stage renal disease; pheochromocytoma