What are the symptoms of adrenal pheochromocytoma

Adrenal pheochromocytoma is common in young and middle-aged people, especially between the ages of 30 and 50. Therefore, patients must understand its symptoms so that we can discover it in time and take effective measures in time. Common symptoms include vasoconstriction, increased heart rate, increased sweating, headache, and pale complexion.

1. As a large amount of catecholamines intermittently enter the blood circulation, blood vessels are constricted, peripheral resistance increases, heart rate accelerates, and cardiac output increases, leading to a paroxysmal sudden increase in blood pressure. The systolic pressure can reach above 26.6 kPa (200 mmHg), and the diastolic pressure also increases significantly. The attacks may be accompanied by palpitations, shortness of breath, chest tightness, headache, pale complexion, heavy sweating, blurred vision, etc. In severe cases, hypertensive crises such as cerebral hemorrhage or pulmonary edema may occur. After the attack is relieved, the patient will feel extremely tired and weak, and the face and other parts of the skin may become flushed. Attacks can be triggered by sudden changes in body position, emotional excitement, strenuous exercise, coughing, and urination and defecation. The frequency and duration of attacks vary greatly among individuals and are not positively correlated with the size of the tumor.

2. Some patients may show persistent hypertension. It is reported that about 90% of pediatric patients and about 50% of adult patients show persistent hypertension. The difference is that there is excessive secretion of adrenaline or norepinephrine. A small number of patients may experience symptoms such as paroxysmal hypotension and shock. This may be related to tumor necrosis, intratumoral hemorrhage, sudden cessation of catecholamine release, or serious cardiac accident. In this case, the prognosis is often poor.

3. Metabolic disorders

Catecholamines stimulate pancreatic α-receptors, causing a decrease in insulin secretion and a reduction in sugar utilization by peripheral tissues, thereby increasing blood sugar or decreasing glucose tolerance. Catecholamines can also promote the secretion of pituitary TSH and ACTH, increase the secretion of thyroid hormone and adrenal cortex hormone, lead to increased basal metabolism, increased blood looseness, accelerated fat decomposition, and cause weight loss. A small number of patients may experience hypokalemia.

4. Other manifestations

Catecholamines can relax gastrointestinal smooth muscles and weaken gastrointestinal motility, thus causing constipation, which is sometimes very stubborn. Severe contraction and spasm of gastrointestinal arterioles can cause gastrointestinal mucosal ischemia, occasionally with symptoms such as necrosis and perforation. Due to the compression of adjacent organs by tumor growth, corresponding clinical manifestations may appear. ?