ENDOCRINE HYPERTENSION (HYPERTENSION) IN A DEPARTMENT OF INTERNAL MEDICINE

Abstract

Objective: The aim of our study was to determine the clinical, paraclinical, etiological and therapeutic profile of secondary HTA of endocrine origin in patients treated in internal medecine department at the University Hospital Sahloul in Tunisia. Design and method: This study investigated various clinicalpathological factors of 27 patients who were diagnosed with endocrine HTA in patients hospitalized in internal medecine department at the University Hospital Sahloul in Tunisia. Results: There were 11 male and 16 female patients. The mean age was 42 years. HTA's average duration of evolution ranged from one month to 24 years. There were 13 cases of neuroendocrine tumors: 11 cases of pheochromocytoma and 2 cases of paraganglioma. Patients with Neuroendocrine tumors had the classic triad of diaphoresis, headache and palpitation associated with cathecholamine/metanephrine excess. The tumor was localized by magnetic resonance imaging(MRI) or 123 I –MIBG imaging and the diagnosis was confirmed by pathological examination after surgery. We have found 6 cases of Conn adenoma, 5 cases of cortical carcinoma, one case of pulmonary cancer's adrenal metastasis, one case of adrenal hyperplasia and one case of hyperaldosteronism secondary to treatment with Ergoloid. The diagnosis was confirmed by hormone dosage which showed elevated plasma aldosterone levels and decreased plasma renin activity in cases of Conn adenoma and adrenal hyperplasia, hypercortisolemia in cases of cortical adenoma, cortical carcinoma and pulmonary cancer's adrenal metastasis. The tumor was localized by CT scann and the diagnosis was confirmed by pathological examination after surgery. Blood pressure normalization was found among16 patients after surgery. Conclusions: HTA of endocrine origin has many etiology witch could have high morbidity and mortality, especially when not properly diagnosed or treated. The potentially curable nature of HTA in more than two thirds of cases, demostrates the importance of early diagnosis of each severe HTA resistant to treatment or in the presence of suggestive clinical, biological or radiological signs.