Pheochromocytoma an Endocrine Disorder

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Pheochromocytoma an Endocrine Disorder

• By Colbie, Patricia,
• Robynne, and Tina

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Pheochromocytoma

• A tumor of chromaffin cells most often located in
  the adrenal medulla (which is an endocrine
  gland).
• Chromaffin cells secrete catecholamines into the
  blood. Examples are norepinephrine, epinephrine.

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His Symptoms of Pheochromocytoma

• Headaches
• Palpitations
• Excessive sweating
• Hypertension
• Mild hyperglycemia
• Unexplained weight loss
• All his symptoms are aggravated during the
  afternoon and with increased levels of stress

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Excessive sweating

• The catecholamines (nor-epinephrine and
  epinephrine) binds to alpha receptors in the skin
  called apocrine glands causing increased sweating

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Hypertension and Headache

• Definition chronically elevated blood pressure
• Catecholamines bind to alpha receptors, causing
  vasoconstriction which makes your heart have to
  work harder against greater resistance to get
  blood flow to the body
• Any secretions by the adrenal medulla of
  epinephrine (as in a reaction to a stressful
  situation) reinforces vasoconstriction and
  exacerbates the hypertension
• Hypertension leads to the severe headaches

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Heart Palpitations

• Catecholamines bind to beta 1 receptors in the
  heart, causing rapid heart rate and increased
  stroke volume, interpreted as palpitations.
• Increased cardiac output also increases blood
  pressure.

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Hyperglycemia

• Catecholamines bind to alpha 1 and beta 2
  receptors in the liver, causing glycogenolysis
• Catecholamines also bind to alpha receptors in
  the pancreas
• This causes decreased insulin release which keep
  the blood glucose levels in the body elevated

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Unexplained Weight Loss

• Increased sympathetic responses in visceral
  effectors (enhanced fight or flight) cause
  increased metabolic rate, thus metabolizing food
  quicker which explains the weight loss.

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Atropine Worsens the Symptoms

• Atropine antagonizes the effects of
  parasympathetic stimulation of visceral effectors
  by inhibiting the binding of Ach at muscarinic
  receptors.
• The sympathetic actions appear to be activated
  because the parasympathetic nervous system is not
  able to contribute to the overall control of the
  visceral organ.

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To Diagnose

• Blood or urine test to measure how much
  adrenaline (epinephrine) breakdown products are
  in the blood or urine
• X-ray or Nuclear scans (i.e. CT, MRI, or MIBG)
  that look for tumors on adrenal gland
• Selective vena cava sampling which is a specific
  blood test from certain blood vessels to test for
  high levels of adrenaline

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Treatment

• Treated by medications that lowers blood pressure
  or surgeries to remove the tumor