Diagnosis method of pheochromocytoma

For pheochromocytoma, of course, we must pay attention to our own diagnosis, so that we can understand in time whether we are affected by this disease and take timely treatment measures. In differential diagnosis, we must also pay attention to avoid confusion with other diseases, such as primary hypertension and intracranial diseases have similar symptoms.

1. Essential hypertension

Some patients with essential hypertension show high sympathetic nervous system excitability, manifested as palpitations, sweating, anxiety, and increased cardiac output. However, the patient's urinary catecholamines were normal. Especially during anxiety attacks, urine collection for catecholamine measurement is more helpful in excluding pheochromocytoma.

2. Intracranial diseases

When intracranial diseases are accompanied by high intracranial pressure, symptoms such as severe headache similar to pheochromocytoma may occur. Patients often have other signs of neurologic impairment that support the underlying disorder. However, we should also be alert to complications such as pheochromocytoma and cerebral hemorrhage.

3. Neuropsychiatric disorders

Anxiety attacks, especially when accompanied by hyperventilation, can be easily confused with pheochromocytoma attacks. However, blood pressure is usually normal during anxiety attacks. If blood pressure is also elevated, it is necessary to measure blood and urine catecholamines to assist in differentiation.

4. Epilepsy

Epileptic seizures may also resemble pheochromocytoma, and sometimes blood catecholamines may also increase, but urine catecholamines are normal. Premonitions before epileptic seizures, abnormal EEG, and effective anti-epileptic treatment can help rule out pheochromocytoma.

5. Menopausal syndrome

Women in the menopausal transition period will experience a variety of symptoms caused by estrogen deficiency, such as hot flashes, sweating, irritability, and uncontrollable mood swings, which are similar to the onset of pheochromocytoma. Understanding the menstrual history and measuring sex hormones and catecholamines can help with the identification.

6. Others

Hyperthyroidism presents with symptoms of high metabolism, accompanied by high blood pressure. However, diastolic blood pressure is normal and catecholamines are not elevated. Angina attacks due to coronary heart disease and acute myocardial infarction need to be differentiated from pheochromocytoma. It can usually be distinguished based on electrocardiogram changes during the attack and effective treatment to improve myocardial blood supply. The most critical is the determination of urinary catecholamines.