Beside the clinical criteria of this tumour, serum and urinary
catecholamine assay will confirm the diagnosis.
Localization of tumour site is mandatory for surgical excision. This
is usually carried out by isotope scanning using the tracer meta-iodo
benzaguanin (MIBG). The tumour is extremely sensitive to X-ray contrast
media, on exposure it will secrete a huge amount of catecholamine with
fatal outcome. So, in hypertensive patient if pheochromocytoma is
expected, this should be excluded first; by catecholamine assay before the
patient is subjected to the contrast media.
Treatment is by hypotensive drugs having A and B-adrenergic
blocking properties as labetalol and carvedilol. They are the drugs of
choice. The definitive treatment is surgical excision.
RENAL DISEASES IN HEPATIC PATIENTS
There are many renal disorders which are known to occur in
cirrhotic patients. These are:
1- Hepatorenal syndrome
2- Cirrhotic glomerulopathy
3- Glomerulopathy induced by infection common in cirrhotic patients
such as:- Malaria • Bilharziasis
- HBV • HCV
4- Tubulointerstitial disorders that are due to:- Infection (brucellosis, mononucleosis, tuberculosis)
- Systemic disease (sarcoidosis, Sjogren's syndrome, lymphoma)
- Drugs (methicillin, ampicillin, penicillin, sulfonamides,
rifampicin, acetaminophen, Allopurinol).