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What Causes Anxiety, Sweats, Flushing And Hypertension?
Question: I have questions about pheochromocytoma. Is my elevated lab level plasma free normetanephrine indicative of this disease? Clinically, I have symptoms of carcinoid, flushing, sweats, anxiety, and new onset hypertension 160/100.
Brief Answer:
Symptoms are suggestive
Detailed Answer:
Hi
Thanks for your query.
Your symptoms are very much suggestive of a neuroendocrine tumor, pheochromocytoma is one such. However, the metanephrine is normal and free normetanephrine is only mildly elevated so that does not favor the diagnosis of pheochromocytoma. But that does not rule out other neuroendocrine tumors like carcinoid either.
Hence I would recommend an ealry endocrinologist or oncologist consult. Whole body imaging may be required by CT, MRI or PET. Also we need to exclude drug history because some drugs can also these kind of symptoms. But not humira.
We need to establish the diagnosis first then appropriate treatment can be initiated. Even if it is a neuroendocrine tumor, surgery can take care of it.
Hope this helps. I will be available for further followup.
Regards
Symptoms are suggestive
Detailed Answer:
Hi
Thanks for your query.
Your symptoms are very much suggestive of a neuroendocrine tumor, pheochromocytoma is one such. However, the metanephrine is normal and free normetanephrine is only mildly elevated so that does not favor the diagnosis of pheochromocytoma. But that does not rule out other neuroendocrine tumors like carcinoid either.
Hence I would recommend an ealry endocrinologist or oncologist consult. Whole body imaging may be required by CT, MRI or PET. Also we need to exclude drug history because some drugs can also these kind of symptoms. But not humira.
We need to establish the diagnosis first then appropriate treatment can be initiated. Even if it is a neuroendocrine tumor, surgery can take care of it.
Hope this helps. I will be available for further followup.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
i have been on levothroxine, metoprolol 25 mg, elavil and cymbalta. Each time I get IV steroids or take them, I crash in the following weeks. I have drenching night sweats, facial flushing and profuse sweating, headaches, neck pain and right facial and neck swelling with right sided blurred vision, right sided weakness, right sided hearing loss and lymph nodes in my chest and neck. My parotid is enlarged on imaging, they've biopsied a sublingual mass in my throat that was benign. Documented a right vocal cord lag with dysphagia and dysphonia. They did a PET scan of brain and whole body and said "it lit up" in the neck and abdomen, but they "don't know the significance of lymph nodes lighting up". I now have "rice crispy" sounding crepitus in my neck and fizzing in the back of my throat but a head neck ct showed no acute problems. I have worse headaches, short term memory loss, diagnosed encephalopathy and on and on. What speciality will help sort this out and can you yourself refer me?
Brief Answer:
drugs may be the culprit here
Detailed Answer:
Overall the imaging results have failed to find out any causative tumor. So that is reassuring. On the other hand cymbalta can cause serotonin syndrome which can explain most of your symptoms. The probability increases when it is combined with elavil.
So I think you should ask your doctor about substituting one or both of these drugs. You can also consult an endocrinologist regarding the serotonin excess sympotoms.
I will not be refer you to any specialist but if you want I can suggest somebody in your locality. You can have a look at the following profile.
https://internalmedicine.osu.edu/endocrinology/directory/lawrence-kirschner/
Regards
drugs may be the culprit here
Detailed Answer:
Overall the imaging results have failed to find out any causative tumor. So that is reassuring. On the other hand cymbalta can cause serotonin syndrome which can explain most of your symptoms. The probability increases when it is combined with elavil.
So I think you should ask your doctor about substituting one or both of these drugs. You can also consult an endocrinologist regarding the serotonin excess sympotoms.
I will not be refer you to any specialist but if you want I can suggest somebody in your locality. You can have a look at the following profile.
https://internalmedicine.osu.edu/endocrinology/directory/lawrence-kirschner/
Regards
Note: For further queries related to kidney problems Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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