CASE REPORT EVALUATING HYPERTENSION IN YOUNG PATIENTS: A CASE REPORT HIGHLIGHTING THE NEED TO CONSIDER PARAGANGLIOMA
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Keywords
Paraganglioma, Hypertension, Catecholamines, Neuroendocrine tumor, Panic attacks
Abstract
Paragangliomas are rare neuroendocrine tumors that secrete catecholamines thus leading to hypertension and tachycardia. This is because paragangliomas in young patients may manifest symptoms that are periodic and thus may be confused with other diseases such as panic disorders and primary hypertension. This case report presents a 17-year-old boy who was diagnosed with hypertension, palpitations, and severe panic attacks for the last two months. He was not a steady candidate of constant blood pressure throughout the day and he had many cases of tachycardia. Biochemical investigations revealed elevated plasma normetanephrine levels suggesting the presence of a catecholamine-producing tumour. These were further supported by a 24-hour urine test which came out higher than the normal range of urinary normetanephrine level. Follow-up MRI and PET-CT scans showed neck lesions in close apposition to the carotid artery but there was no evidence of metastatic disease. Therefore the diagnosis of paraganglioma was made and the patient was scheduled for surgical removal of the tumours. This case emphasizes the diagnostic challenges in patients with paraganglioma especially when they are young and present with episodic hypertension and panic-like symptoms. Both biochemical and imaging studies should be implemented during the first stage of the disease to prevent complications such as hypertensive crises or tumor metastasis and to give adequate treatment.
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Dr. Mugi Anju
MBBS, General Physician, Dr. N.T.R University Of Health Sciences
Dr. Bhargavasairam Pajjuru
MBBS, General physician Penugonda hospital
Dr Prathyusha Vangala
MBBS, General physician, Bristlecone Hospitals, Barkatpura, Hyderabad
Dr.Godaba Govardhana Sai Kumar
MBBS, Working as -medical officer, DMHO, Visakhapatnam, Andhra Pradesh
Dr. Markonda Patnaikuni Navya
MBBS, Current Working Status :- Lecturer, Forensic Medicine, Mims College & Hospital,Andhra Pradesh