Marc A.J. Seelen, MD; Paul H.E.M. de Meijer, MD, PhD; A. Edo Meinders, MD, PhD
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
Seelen M., de Meijer P., Meinders A.; Serotonin Reuptake Inhibitor Unmasks a Pheochromocytoma. Ann Intern Med. 1997;126:333. doi: 10.7326/0003-4819-126-4-199702150-00021
Download citation file:
Published: Ann Intern Med. 1997;126(4):333.
TO THE EDITOR:
We describe a 55-year-old man with attacks of headache, nausea, palpitations, and perspiration after the dose of paroxetine (a serotonin reuptake inhibitor prescribed for depression) was doubled to 40 mg/d. His other medications were atenolol and a benzodiazepine. Physical examination showed that the patient was agitated and had striking peripheral vasoconstriction. Blood pressure varied between 240/130 and 80/40 mm Hg; the patient did not have orthostatic hypotension. Because of the patient's paroxysmal symptoms and striking changes in blood pressure, a pheochromocytoma was suspected. A 24-hour urinalysis showed noradrenalin, 9.2 nmol (normal, 0.06 to 0.47 nmol); adrenalin, 27 nmol (normal, <0.16 nmol); and vannillylmandelic acid, 147 mmol (normal, <30 mmol). A tentative diagnosis of pheochromocytoma was made. Computed tomography of the abdomen showed a mass of approximately 4 cm in diameter in the left adrenal gland. Results of pathologic examination after left-sided adrenalectomy were compatible with pheochromocytoma. After surgery, the patient had no symptoms and was normotensive.
to gain full access to the content and tools.
Learn more about subscription options.
Register Now for a free account.
Copyright © 2016 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use
This PDF is available to Subscribers Only