Pseudopheochromocytoma-an epidemic of the modern world? Case series and review of literature

Background: Pseudopheochromocytoma is a condition that occurs more frequently than other diseases presenting with similar symptoms such as: paroxysmal hypertension, diaphoresis, pallor, palpitations. However, due to the lack of specific guidelines and awareness among physicians, it is widely underdiagnosed. Conventional antihypertensive treatment is ineffective in controlling symptoms which leads to decreased quality of life in patients affected by this disorder.Case presentation: In our paper, we present three female patients with paroxysmal hypertension who were admitted to the Department of Endocrinology for an investigation of suspected pheochromocytoma. The biochemical findings and imaging carried out at the hospital ruled out the diagnosis of an adrenal tumor in all three of the patients. Given the proposed criteria the clinical features of the patients were suggestive of pseudopheochromocytoma. In all three cases, the anxiolytic or SSRI treatment was applied with satisfactory symptom control. Conclusions: After ruling out pheochromocytoma in patients presenting with paroxysmal hypertension, physicians should consider a diagnosis of pseudopheochromocytoma. Management of the disorder should include anxiolytic, antidepressant, a-adrenoceptor blockers, and b-adrenoceptor blockers treatment, with close cooperation between hypertension specialist and psychiatrist or psychologist. Early proper diagnosis can reduce emotional distress related to an extensive diagnostic process as well as the overall cost of healthcare in patients with pseudopheochromocytoma.