- Last edited on May 16, 2021
Differences
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anxiety:panic [on January 20, 2020] |
anxiety:panic [on January 20, 2020] |
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| * Pheochromocytoma, rarely, this should be considered on the differential. Especially if the patient is not responding to conventional treatments[([[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5890079/|Alguire, C., Chbat, J., Forest, I., Godbout, A., & Bourdeau, I. (2018). Unusual presentation of pheochromocytoma: thirteen years of anxiety requiring psychiatric treatment. Endocrinology, diabetes & metabolism case reports, 2018.]])][([[https://www.endocrine-abstracts.org/ea/0032/ea0032p569|Muroya, Y., Kumagai, N., Shimodaira, M., Tsuzawa, K., Sorimachi, E., Arioka, H., & Honda, K. (2013, April). A case of pheochromocytoma that recognized as panic disorder before its exact diagnosis. In 15th European Congress of Endocrinology (Vol. 32). BioScientifica.]])] | * Pheochromocytoma, rarely, this should be considered on the differential. Especially if the patient is not responding to conventional treatments[([[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5890079/|Alguire, C., Chbat, J., Forest, I., Godbout, A., & Bourdeau, I. (2018). Unusual presentation of pheochromocytoma: thirteen years of anxiety requiring psychiatric treatment. Endocrinology, diabetes & metabolism case reports, 2018.]])][([[https://www.endocrine-abstracts.org/ea/0032/ea0032p569|Muroya, Y., Kumagai, N., Shimodaira, M., Tsuzawa, K., Sorimachi, E., Arioka, H., & Honda, K. (2013, April). A case of pheochromocytoma that recognized as panic disorder before its exact diagnosis. In 15th European Congress of Endocrinology (Vol. 32). BioScientifica.]])] | ||
| * The classic triad of pheochromocytoma symptoms includes headache, excessive sweating, and palpitations. Around 15%-20% of patients with a pheochromocytoma patients may be normotensive. | * The classic triad of pheochromocytoma symptoms includes headache, excessive sweating, and palpitations. Around 15%-20% of patients with a pheochromocytoma patients may be normotensive. | ||
| - | * Testing for plasma metanephrines (95% sensitivity) and 24-hour urinary metanephrines (99% sensitivity) is useful. Abdominal CT has also been shown to be helpful. However, on MRI, pheochromocytomas demonstrate a distinctive appearance (100% sensitivity), and scintigraphy using metaiodobenzylguanidine (a norepinephrine analog) labeled with I-131 (I-MIBG) is particularly good at locating extra-adrenal pheochromocytomas. | + | * Plasma metanephrines (95% sensitivity), 24-hour urinary metanephrines (99% sensitivity), MRI (100% sensitivity, pheochromocytomas demonstrate a distinctive appearance), scintigraphy, and abdominal CT.[([[https://www.clinicaladvisor.com/home/features/an-incidental-finding-twice-removed-in-an-anxious-patient/|Clinical Advisor: An incidental finding, twice removed in an anxious patient]])] |
| ===== Investigations ===== | ===== Investigations ===== | ||
| * TSH, glucose as baseline if not already done | * TSH, glucose as baseline if not already done | ||