Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Treatment For High BP
Question: hello doctor,
myself XXXXXXX XXXXXXX age-31 yrs, married, having 2 kids one of 4yrs and another of 2 yrs old.
i have high bp problem since last 6-7 years but it remains controlled if i take regular bp medicine,
in between i consulted many of the medicine doctors for this problem , and had regular check-ups like LFT, KFT, ECG , Heast Ultrasound etc and everytime reports were normal.
15 days ago i went to nepherologist as one of my family doctor told me to get my kidney checked .
doctor advised Ultrasound KUB, and renal doppler. In reports there was some 2.5 cm legion inside my right adrenal gland, so doctor suspected pheochromocytoma and told me for the 24 hr urine test for the Catecholamines & Vma Level, in Reports Epinephrine, Norepinephrine, dopamine,metanephrines and normetanephrines were in normal range. VMA was very slightly increase ( just 1 point) .
please suggest me what it could be and how to proceed futher for the investigations and treatment.
also please suggest if i need to restrict my diet in future.
myself XXXXXXX XXXXXXX age-31 yrs, married, having 2 kids one of 4yrs and another of 2 yrs old.
i have high bp problem since last 6-7 years but it remains controlled if i take regular bp medicine,
in between i consulted many of the medicine doctors for this problem , and had regular check-ups like LFT, KFT, ECG , Heast Ultrasound etc and everytime reports were normal.
15 days ago i went to nepherologist as one of my family doctor told me to get my kidney checked .
doctor advised Ultrasound KUB, and renal doppler. In reports there was some 2.5 cm legion inside my right adrenal gland, so doctor suspected pheochromocytoma and told me for the 24 hr urine test for the Catecholamines & Vma Level, in Reports Epinephrine, Norepinephrine, dopamine,metanephrines and normetanephrines were in normal range. VMA was very slightly increase ( just 1 point) .
please suggest me what it could be and how to proceed futher for the investigations and treatment.
also please suggest if i need to restrict my diet in future.
Brief Answer:
Need further tests
Detailed Answer:
Dear XXXXXXX XXXX,
Good day.
Noted your concern.
The incidental finding of an adrenal mass durng scan is called as incidentaloma. We need to find out couple of things
1) IS the lesion producing excess hormones
2) Is it a benign or cancerous one?
While evaluating such a swelling, we ask for few tests.
a) 24 hours Urine VMA and Metanephrines
b) 24 hours urine free cortisol
c) Serum aldosterone, Renin ratio
Noted the catecholamine test in urine.However, 24 hour urine Metanephrines would have been better. Please do nt worry about VMA. A number of food including tea/coffee/chocolate etc can cause false elevation of VMA.
PLEASE MEET AN ENDOCRINOLOGIST. He will arrange these tests. Many precautions and drug modifications have to be done prior to doing these tests. An endocrinologist will be able to help you further.
Regards
Binu
Need further tests
Detailed Answer:
Dear XXXXXXX XXXX,
Good day.
Noted your concern.
The incidental finding of an adrenal mass durng scan is called as incidentaloma. We need to find out couple of things
1) IS the lesion producing excess hormones
2) Is it a benign or cancerous one?
While evaluating such a swelling, we ask for few tests.
a) 24 hours Urine VMA and Metanephrines
b) 24 hours urine free cortisol
c) Serum aldosterone, Renin ratio
Noted the catecholamine test in urine.However, 24 hour urine Metanephrines would have been better. Please do nt worry about VMA. A number of food including tea/coffee/chocolate etc can cause false elevation of VMA.
PLEASE MEET AN ENDOCRINOLOGIST. He will arrange these tests. Many precautions and drug modifications have to be done prior to doing these tests. An endocrinologist will be able to help you further.
Regards
Binu
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Does the tests which i sent you doesnt rule out the possibilty of it being a cancereous one?
Brief Answer:
No.
Detailed Answer:
No, it doesnt. We need to look at other features in CT scan. Sometimes an FNAC ( needle test ) is required.
No.
Detailed Answer:
No, it doesnt. We need to look at other features in CT scan. Sometimes an FNAC ( needle test ) is required.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Okay, i will go through all the tests, i got appointment after 2 days, is it a emergency siruation? Is it curableShall i go to doctor right now?
If not then one more thing can i take tea/ coffe/ alcohal etc till i see any doctor??
If not then one more thing can i take tea/ coffe/ alcohal etc till i see any doctor??
Brief Answer:
Better to avoid these things before VMA test
Detailed Answer:
Dear XXXXXXX
At your age, it is very unlikely to be cancerous. However, we need to rule out cancer and hormone secretion. CT features are prime and your endocrinologist will be able to look at the scan report and comment further. You may meed someone in XXXXXXX or in XXXXXXX There are several endocrinologists in XXXXXXX Medanta hospital etc.
Absolutely no need to hurry. If it is hormonr secreting one, it need to be removed. If not and if not cancerous, it need to be followed up with an annual CT scan
If planning for urine VMA, it is better to avoid tea, coffe, chocolates, cola, banana, vanilla icecream etc atleast 3-4 days before that.
Better to avoid these things before VMA test
Detailed Answer:
Dear XXXXXXX
At your age, it is very unlikely to be cancerous. However, we need to rule out cancer and hormone secretion. CT features are prime and your endocrinologist will be able to look at the scan report and comment further. You may meed someone in XXXXXXX or in XXXXXXX There are several endocrinologists in XXXXXXX Medanta hospital etc.
Absolutely no need to hurry. If it is hormonr secreting one, it need to be removed. If not and if not cancerous, it need to be followed up with an annual CT scan
If planning for urine VMA, it is better to avoid tea, coffe, chocolates, cola, banana, vanilla icecream etc atleast 3-4 days before that.
Note: For further queries related to kidney problems and comprehensive renal care, talk to a Nephrologist. Click here to Book a Consultation.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
