Clinical Chemistry Blog Notes 8d-B

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Disease is the tax which the soul pays for the body, as the tenant pays house-rent for the use of the house.”- Ramakrishna

No one can break away from the power of disease; everyone amid us can be a victim of whichever disease that is caused by our action or by any situation. I personally suffered from different kinds of diseases, from mild to severe ones. Others may think that they did not yet suffer from a disease, but that’s so impossible. One day our body will acquire weariness on all the things we do and this will pay off with a lot of infirmity.  No one can escape with the reality that our body will become exhausted in a little while as we carry out our day after day customs.  Nevertheless, one of our most treasured dreams is to have a healthy living. Even if we seize to take good care of our self, we cannot really presume when we will have a disease.And so, we must then be cautious on what we do to prevent diseases in our lives.

As I go along with my blog, I want to share with you different kinds of uncommon diseases that are specific for adrenal medulla, which can be seen in our kidney; I want you, my readers, to gain more knowledge about some diseases that you may encounter. Furthermore, I want you become aware of the signs and symptoms of these diseases.

According to statistics of CDC/National Center for Health Statistics, the 8th cause of death in United States is kidney diseases. It means that there are a lot of people suffering from these diseases, so why not tackle about some of these? Two of the most common are pheochromocytoma and paragangliomonas.

Does it sound familiar to you?

I, myself, don’t really even know what these diseases are at first.

Pheochromocytoma and paragangliomas are rare types of catecholamines producing tumors.These diseases are formed by the adrenal glands and can be located anywhere in our body. These can then control normal body stress reaction by producing hormones.

 

Pheochromocytoma

Pheochromocytoma
Pheochromocytoma (Photo credit: Wikipedia)

It is said that pheochromocytomas are 85-90% found in the adrenal glands, while 98% in the abdomen. It is the additional production of catecholamines in the body that can have a severe effect on us, because our homeostasis is altered.

Symptoms and Signs

The common symptoms and signs are:

    • A sense of approaching disaster
    • Abdominal pain
    • Angina
    • Chest pain
    • Clammy skin
    • Cold
    • Constipation
    • Diaphoresis
    • Dizziness
    • Dyspnea
    • Elevated blood sugar
    • Epigastric pain
    • Facial flushing (redness)
    • Hypertension
    • Increased respiratory rate
    • Nausea,
    • Nervousness, anxiety, and irritability
    • Pale skin tone
    • Palpitations
    • Paresthesia
    • Postural hypotension
    • Severe headache
    • Sweating
    • Tachycardia
    • Tachypnea
    • Visual disturbances
    • Vomiting
    • Weight loss

Norepinephrine, epinephrine, and dopamine are the one being secreted by catecholamines. If epinephrine is introduced in the body or more volume is secreted there will be hypertension, sweating and headache that can suggest pheochromocytoma.

Diagnosis

Diagnostic tests for pheochromocytoma include the following:

  • 24-hour urinary collection for catecholamines and metanephrines
  • Chest and abdomen imaging (CT or MRI) if catecholamine screen positive
  • Consultation with an ophthalmologist to rule out retinal angiomas (VHL disease)
  • Genetic testing for mutations causing the MEN 2A and 2B syndromes
  • PET scanning: for the detection and localization of pheochromocytomas
  • Possibly nuclear imaging with 123 I-meta-iodobenzylguanidine (MIBG)

*Catecholamines that are found in urine and serum may indicate pheorchomocytoma

Treatment

The removal of the tumor is the treatment of choice. On the other hand the patient is said to first take drugs before doing the operation, if the patient is experiencing hypertension. Also medications such as chemotherapy can kill the tumor cells; and radiotherapy can destroy the tumors.

 

Paragangliomonas

English: Location of major endocrine glands
English: Location of major endocrine glands (Photo credit: Wikipedia)

This is also called, Pharmacologic Time Bomb. This is a time bomb in our body, which is a tumor than can lead to a malignant one if it is not removed at its early stage. These tumors are found outside the adrenal medulla and are also called extra-adrenal pheochromocytoma or paragangliomonas. It is a time bomb because it releases adrenaline hormone. We all know that adrenaline is a fight or flight response in our body that reacts with stressful situation. Raising heart rate and blood pressure may occur also there will be a great oxygen intake that will lead to the brains and muscles; so if this hormone will be secreted, our homeostasis in our body will be affected. So if you have this kind of disease you must be careful in all your actions and make a considerable decision to remove tumors in your body. This is also called Sympathetic paragangliomonas; these tumors are found in the chest abdomen or in the pelvis. Also this is more malignant comparing it to the pheochromocytoma. There is also parasympathetic paragangliomonas located in the head and neck tissues. It is then called “head and neck paragangliomonas”.

Signs and Symptoms

  • Heart palpitations
  • Irregular heartbeat
  • Hypertension
  • Sweating  

Diagnosis

In the diagnosing of the disease, a tumor biopsy is used. However, it cannot be differentiated if it is a malignant or a benign paragangliomonas. It can only tell if it is a malignant when other organs are infected. So even if it is a benign one, the tumor must be removed already so that it will not spread in the body.

Treatment

The treatment of the disease is the removal of the tumor in the form of surgery and radiotherapy can also be used.