Centre For Diabetes, Thyroid, Obesity & Endocrinology

Cushing’s disease occurs due to excess cortisol production resulting from a malfunctioning pituitary gland. The pituitary gland is present at the base of the brain. In this condition, a non-cancerous tumour on the gland induces it to release excessive adrenocorticotropic hormone (ACTH). ACTH further fuels the adrenal glands to produce more cortisol. Cortisol affects entire organs and tissues in the body, leading to their abnormal growth syndrome called Cushing disease. Associated Anatomy of Cushing's Disease Pituitary gland: An organ of the endocrine system Alternative Name of Cushing's Disease ACTH-Secreting Adenoma, Pituitary Cushing’s Disease Cushing's Disease Causes The following factors can cause Cushing’s disease: The long-term high dosage of cortisol (injectable or oral) is the most common cause. Glucocorticoids are examples of cortisols. These medicines treat conditions such as lupus, asthma, and rheumatoid arthritis. One can also find them in asthma inhalers and skin ointments. Few people also develop this disease as their bodies produce too much cortisol. Several tumours can accelerate the production of excess cortisol. Several tumours can also cause a higher production of cortisol. For instance: pituitary gland tumours, ectopic tumours (they usually occur in the thymus gland, lung, thyroid, or pancreas), and adrenal gland tumours or abnormalities. When it is adrenal tumour, excess production of cortisol is independent of ACTH which are actually low in this condition. Cushing's Disease Symptoms Common signs and symptoms of cushings disease include: Weight gain Muscle weakness Skin darkening Fatty tissue deposits (more around the upper back and midsection), shoulders (buffalo hump), and face (moon face) Purple or pink stretch marks on abdominal skin, arms, thighs, and breasts More acnes Fragile and thin skin prone to bruising Rapid bone loss, more prone to fractures Slow healing of infections, cuts, and insect bites Anxiety, irritability, and depression Lesser emotional control New episodes of high blood pressure Impaired growth (among children) Signs and symptoms among women An increase in thicker facial or body hair Irregular menstrual periods or absent periods Signs and symptoms among men Erectile dysfunction Lower sex drive Decreased fertility. Stages of Cushing's Disease As the changes in appearance and body develop gradually, decoding the early stages of Cushing’s disease is difficult. The hormone elevations appear and disappear. Therefore, one can term them ‘periodic’ or ‘cyclical’ Cushing’s disease, making the diagnosis more difficult. Cushing's Disease Diagnosis If you are not using any corticosteroid medication, the following diagnostic tests may help in identifying Cushing’s disease: Urine and blood tests You must undergo these tests to determine hormone levels to check if your body produces too much cortisol. The healthcare professional may ask you to take 24-hour urine free cortisol (UFC) measurement. This test collects and examines urine for over 24 hours. Medical professionals also analyse your blood samples to gauge cortisol levels. Saliva test Cortisol levels keep rising and falling during the day and fall drastically during the evening. Therefore, analysing several saliva samples collected late at night helps in decoding the high cortisol levels. Imaging tests Magnetic resonance imaging (MRI) or computerised tomography (CT) scans help examine tumours and other abnormalities in your adrenal and pituitary glands. Petrosal sinus sampling Pathologists carry out this sampling test to confirm if the root cause of the disease is in the pituitary gland or somewhere else. Cushing's Disease Treatment The treatment options for Cushing’s disease focus on lowering the cortisol level in the body. Some of the best treatments are: Reducing the corticosteroid use Suppose you suffer from Cushing’s disease due to the long-term usage of corticosteroid medications. In that case, your doctor can reduce the dosage while maintaining your condition. Please Note: Do not start or stop taking these medications without your doctor’s supervision. Surgery Your doctor may recommend the removal of tumours through a surgical process. Medical professionals can remove pituitary tumours through a nasal procedure. However, the adrenal glands, pancreas, or lungs require minimally invasive surgical techniques. Radiation therapy If the pituitary tumour is not removed even after surgery, the doctor will also prescribe you radiation therapy. Radiation is typically for patients who can’t undergo surgery. Medications If both surgery and radiation don’t work, you can be prescribed medications to control cortisol production. Such medicines include: Metyrapone (Metopirone) Pasireotide (Signifor-injectable) Ketoconazole Osilodrostat (Isturisa) Mitotane (Lysodren) Surgery of adrenal glands If all the treatments mentioned above fail, your doctor might recommend bilateral adrenalectomy. It is a surgical process that includes the removal of adrenal glands. While the process cures excessive cortisol production, it requires lifelong replacement medications. Risk Factors of Cushing's Disease Factors that can increase the risk of Cushing disease are: Long-term use of high doses of corticosteroids You are an adult female. Your age is between 20 to 50 years. You are living with adrenal or pituitary tumours. Possible Complications of Cushing's Disease Cushing’s disease can lead to several health problems like: Deep vein thrombosis (blood clots in veins) Mood swings or related psychiatric problems Compression fractures in the spine Diabetes Frequent infections Heart attack or stroke Memory loss or trouble concentrating High blood pressure Kidney stones Weight gain Cushing's Disease Preventions Cortisol is integral for carrying out several functions like managing respiration, regulating blood sugar levels, turning food into energy, helping in coping with stress, and more. However, too much cortisol is your body’s enemy. For primary prevention, get your cortisol levels monitored from time to time, especially if you are taking steroids or glucocorticoids. However, there is no way to avoid or prevent tumours causing Cushing’s disease. Epidemiology of Cushing's Disease Pituitary adenomas (Cushing’s disease) affect about 60 to 70 percent of adolescents and children and over 70 percent of adults. Cushing’s syndrome is prevalent among women and affects adults in the age group of 20 to 50. They account for around 70 percent of the total cases. Expected Prognosis of Cushing's Disease Cushing’s disease can lead to severe illness and even death if left untreated. However, removing the tumour might help you recover fully, but there are chances of the tumour growing back. Natural Progression of Cushing's Disease Cushing’s disease can lead to severe illness and even death if left untreated. Pathophysiology of Cushing's Disease The adrenal gland secretes steroid hormones and cortisol stimulated by excessive ACTH. The pituitary gland secretes ACTH, while the hypothalamus secretes the corticotropin-releasing hormone. The latter causes the ACTH to transfer to the petrosal venous sinuses. Related Blogs Understanding Hip Fractures: What Are The Different Types Of Hip Fractures? Small-Cell Lung Cancer vs. Non-Small-Cell Lung Cancer: Unraveling the Differences

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Gestational diabetes is a metabolic disorder that occurs in pregnant women. Gestational diabetes is characterised by high blood sugar levels that may be harmful to the pregnancy. Gestational diabetes usually goes away after delivery; however, it increases the risk of developing type 2 diabetes mellitus. Associated Anatomy of Gestational Diabetes Pancreas, Placenta Additional Type of Gestational Diabetes There are two subclasses of gestational diabetes, class A1 and A2 gestational diabetes. Class A1 gestational diabetes can be managed with diet alone, while class A2 gestational diabetes will require medications to ensure adequate glycemic control. Gestational Diabetes Causes The exact cause of gestational diabetes remains unknown. However, researchers hypothesise the following reasons can cause gestational diabetes- Insulin resistance: The placenta produces certain hormones that help the baby during pregnancy. Over time, these hormones build up in the body and counteract the effects of insulin. This results in insulin resistance. Inadequate insulin production: Sometimes, the pancreas does not produce enough insulin. Without adequate insulin, glucose builds up in the blood, causing hyperglycemia. Gestational Diabetes Symptoms Gestational diabetes generally is not associated with any symptoms. However, certain individuals may experience the following symptoms- Blurred vision Fatigue or tiredness Excessive thirst Frequent urge to urinate Nausea Yeast infections Gestational Diabetes Diagnosis & Tests The American Diabetes Association (ADA) recommends routine checks for gestational diabetes in pregnant women. However, if there is no history of diabetes mellitus or if the blood glucose levels were normal during the start of pregnancy, screening for gestational diabetes is performed when the pregnancy is about 24-28 weeks old. The glucose challenge test and oral glucose tolerance test are a couple of tests performed to diagnose gestational diabetes. Gestational Diabetes Treatments It is critical to initiate treatment as early as possible to protect the health of the mother and the baby. Possible treatments are as follows: Lifestyle modifications: How you remain active plays an essential role in managing gestational diabetes. Exercise: Staying physically active can control blood sugar levels. Physical activity can also help in certain discomforts experienced during pregnancy like swelling, back pain, cramps, constipation, etc. Healthy diet: Having a healthy and balanced diet consisting of fruits, vegetables, lean proteins, whole grains, etc., is critical for positive outcomes. A dietician can help you create a personalised diet plan based on your requirements. Medications: If exercise and diet are not adequate to control blood sugar levels, the doctor usually prescribes insulin or to control blood glucose levels. Blood sugar monitoring: Pregnant women would be asked to monitor their blood sugar levels 3-4 times daily to maintain a healthy blood glucose level. Risk Factors of Gestational Diabetes Women over 25 years of age and a descendant of Asian, African, Native American, Hispanic, or Pacific Island lineage are at an increased risk of developing gestational diabetes. Additionally, the following are some factors that may increase the chances of developing the disease: Prediabetes Overweight High blood pressure Obesity Lack of physical activity Family or personal history of gestational diabetes Medications (like steroids) that interfere with the actions of insulin Previously delivered a baby weighing more than 9 pounds. Have disorders like acanthosis nigricans, polycystic ovary syndrome (PCOS), or other disorders that can cause insulin resistance. Possible Complications of Gestational Diabetes Gestational diabetes can cause complications to the mother as well as the baby. Possible complications to the mother include high blood pressure (preeclampsia), type 2 diabetes mellitus, caesarean birth, etc. The fetal complications include obesity, hypoglycemia, breathing difficulties, diabetes, and premature birth. Gestational Diabetes Preventions Primary Prevention of Gestational Diabetes Gestational diabetes cannot be prevented completely. However, specific steps can reduce the risk of developing the disorder. Maintaining a healthy body weight: If you are overweight and plan to have a baby soon, losing weight will significantly reduce the risk of gestational diabetes. Exercise regularly: Mild exercise like walking can also help in reducing the risk of getting the disorder. Ensuring a healthy diet: Consult with your dietician to curate a personalised diet to ensure you eat nutritious foods before and during pregnancy. Secondary Prevention of Gestational Diabetes Regular follow-up visits with your medical practitioner, eating a healthy diet, and exercising will significantly decrease the risk of developing gestational diabetes in your pregnancy. Epidemiology of Gestational Diabetes Every year about 2-10% of women are diagnosed with gestational diabetes in the United States of America. India accounts for almost 5 million cases each year. Women diagnosed with gestational diabetes are at an increased risk (about 35- 60%) of developing type 2 diabetes mellitus soon (about 10-20 years after pregnancy). Expected Prognosis of Gestational Diabetes Gestational diabetes is a common diagnosis during pregnancy. It usually disappears following delivery. With adequate measures to maintain blood sugar levels, it is possible to have a healthy pregnancy and baby. Natural Progression of Gestational Diabetes Gestational diabetes requires immediate actions following diagnosis. If it is not taken care of, it can cause complications for both mother and the baby. Related Blogs PCOS: No More Silent Struggle! Double Marker Test in Pregnancy and Their Cost, Risk, Result & Benefits

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Graves disease is an autoimmune disorder that results in a condition called hyperthyroidism. This means that there is an overproduction of the thyroid hormone in the body. Associated Anatomy of Graves Disease Thyroid Gland Alternate Name of Graves Disease Toxic Diffuse Goitre Graves Disease Causes There are no specific causes for autoimmune disorders as they are usually a result of genetic predisposition and environmental factors. There are no exact causes known yet for Graves’ disease. In this disorder, an autoimmune condition results in the overproduction of an antibody called thyroid-stimulating immunoglobulin (TSI), which causes excessive thyroid hormone production by the thyroid gland. Graves Disease Symptoms The most prominent symptom of Graves’ disease is increased thyroid hormone. Other visible signs and symptoms include: Enlarged thyroid gland resulting in a condition called goitre Inflammation of the eyeballs that cause the eyes to protrude or bulge out of their sockets Insomnia or trouble sleeping Irregular heartbeats or arrhythmia Fatigue, nausea, weakness due to loss of weight Muscle weakness resulting in hand tremors Greater sensitivity to heat, or even heat intolerance Irregular menses in women Erectile dysfunction in men. Stages of Graves Disease Graves’ disease does not progress over time unless it is left untreated. With proper medication and disease management, a healthy life is possible with Graves’ disease. Graves Disease Diagnosis Graves’ disease is diagnosed using routine thyroid tests like blood tests that detect the thyroid hormone levels, radioactive iodine tests, or an imaging scan of the thyroid glands. For confirmatory diagnosis, the doctors may run an antibody test that measures the thyrotropin-binding inhibitory immunoglobulins (TBII) antibodies and TSI. Differential Diagnosis of Graves Disease Differential diagnosis of Graves’ disease from hyperthyroidism detects the presence of an enlarged thyroid gland and ophthalmological symptoms such as protruding eyeballs out of sockets. This condition is a complication of untreated Graves’ disease and is a differential symptom. Moreover, hyperthyroidism with anaemia, vitamin D deficiency and presence of TSI markers is a typical case of Graves disease. Graves Disease Treatment Since Graves’ disease is an autoimmune disorder, there is no treatment yet that can cure this condition. However, the visible signs and symptoms caused due to excessive thyroid hormone in the body can be reduced. Medications Anti-thyroid medications are not a permanent solution but are administered to decrease thyroid hormone production and, therefore, reduce the symptoms. Although typically used for blood pressure, Beta-blockers are given to alleviate symptoms. Surgery In cases where medication cannot yield any significant effect, surgery is recommended to remove the thyroid gland itself. Radioactive therapy In radioactive therapy, radioactive iodine is given orally to patients, which on entering the body attacks some of the thyroid cells and kills them, thereby reducing the production of thyroid hormone. This may be used in combination with medications. Risk Factors of Graves Disease Autoimmune disorders are caused due to genetic predispositions combined with environmental factors. However, some other risk factors for Graves’ disease are: Gender Women are more susceptible to Graves’ disease than men. Family history A family history of thyroid problems or any other autoimmune disorder such as rheumatoid arthritis, diabetes, etc. can put one at more risk for Graves’ disease. Existing diseases Existing conditions like Celiac disease, Vitiligo, Pernicious Anaemia, or hormonal disorders like Addison’s disease can make someone more likely to develop Graves’ disease. Possible Complication of Graves Disease A possible complication of Graves’ disease is osteoporosis. The thyroid hormone plays a crucial role in the metabolism of vitamin D and bone formation. Due to imbalanced hormone levels, metabolism is affected and osteoporosis may develop. Graves Disease Preventions Primary Prevention of Graves Disease A primary prevention strategy is yet to be developed as there is no way of knowing the exact cause of Graves’ disease. People with existing thyroid conditions should avoid smoking or any other recreational activity that involves nicotine and should control their alcohol consumption. In certain patients with higher thyroid levels, studies recommend using external antibodies to neutralise the excessive thyroid hormone production and prevent hyperthyroidism. Secondary Prevention of Graves Disease For people with existing hyperthyroidism, secondary prevention includes: Screening for TSH antibodies Administration of radioactive iodine Treatment with thyroid medications Graves’ disease is unlikely to progress if monitored regularly with appropriate medications and treatment. Epidemiology of Graves Disease Graves’ disease is a rare autoimmune disorder, and is more likely to affect women than men. Typically, people in their 30s to 50s are more susceptible to Graves’ disease. Expected Prognosis of Graves Disease Graves’ disease is easily manageable with medication and constant attention. It does not increase the mortality rates of a person if appropriately managed. Natural Progression of Graves Disease If left untreated, Graves’ disease can result in a condition called Thyroid storm due to the excess of thyroid hormone in the body. This is a rare event. More common events of untreated thyroid are weakening of heart muscles, heart problems or brittle bones. Pathophysiology of Graves Disease Due to the disease’s autoimmune nature, the immune system of the body attacks the cells of the thyroid gland, and causes overproduction of TSIs. This causes the thyroid gland to produce excess thyroid hormone, which imbalances the body’s metabolism and may affect other organ functions. Related Blogs Warning Signs of Lung Disease You Must Not Ignore Ovarian Cancer Symptoms: Preventive Measures & When to Seek Care?

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The thyroid is a gland located in the lower part of the neck, below the voice box. It secretes thyroid hormone. Hypothyroidism is a condition resulting from decreased secretion of thyroid hormone. Hypothyroidism can result from a disease of the pituitary gland, Hashimoto’s disease, inflammation of the thyroid gland or certain medications. Generally, women are more prone to hypothyroidism than men. Hypothyroidism is more common in the middle age group. But, it can affect infants as well. Hypothyroidism affects the normal metabolism of a person. A person with hypothyroidism gains more weight, feels very tired, and cannot bear the cold temperature. Undergoing treatment can help the thyroid gland to secrete thyroid as normal. Associated Anatomy of Hypothyroidism The thyroid gland is located on both sides below the voice box in the lower part of the neck. Alternate Name of Hypothyroidism The other name for hypothyroidism is an underactive thyroid. Hypothyroidism Causes Hypothyroidism is caused by one or a combination of the following factors: Hashimoto’s disease The immune system attacks the thyroid glands due to an autoimmune disease. This is the most common reason for hypothyroidism. Congenital hypothyroidism A condition of decreased thyroid secretion from childbirth. Thyroiditis Thyroid gland inflammation causes a condition called thyroiditis, resulting in hypothyroidism. Thyroid treatment Surgical treatment by the removal of the thyroid gland, radiation treatment to treat hyperthyroidism, or medication for hyperthyroidism can result in hypothyroidism. Pituitary disease In some people, intake of more iodine or too less iodine in their food can result in pituitary disease. Hypothyroidism Symptoms Early-tage hypothyroidism rarely causes any symptoms. The symptoms may appear different in each person. It may even take months or years to identify the condition. Dryness of skin, hair A depressed state of mind The sudden gain in weight on the face and all over the body Inability to tolerate very low temperatures Fatigue Reduction in the secretion of sweat Inflammation of thyroid glands Symptoms in women Irregular or heavy menstruation Fertility issues Least common symptoms Muscle pain Heart rate reduction Constipation Hypothyroidism Diagnosis Hypothyroidism is difficult to detect since the symptoms are very common, and it may even take a few months to years to confirm the condition. The diagnosis of hypothyroidism is made by the following: Physical examination - In the case of hypothyroidism, the thyroid gland below the voice box is swollen. Medical history - Family history of hypothyroidism and medical history of undergoing any treatment for a thyroid disorder is considered. Thyroid test - Thyroid Stimulating Hormone (TSH), T3, T4 and thyroid antibody blood tests are done to detect the hormone levels. Thyroid gland scan - A thyroid scan, radioactive iodine uptake test and ultrasound are done to check the appearance and functioning of the thyroid gland. Hypothyroidism Treatment The treatment for hypothyroidism usually depends on the patient’s overall health condition and the severity of the disease conditions. It includes factors such as age, cause of the hypothyroidism, and severity of hypothyroidism. Some common treatment options include: Hormone therapy Hormone therapy is replacement of the thyroid hormone with medicines. After starting the medicine for 6-8 weeks, a blood test will be done. Your doctor will adjust the dosage of the medicine based on the blood test results to measure the level of thyroid hormone. Once the right dosage is found, the blood test is done once a year. Managing hypothyroidism People with Hashimoto’s thyroiditis and other factors contributing to hypothyroidism have to be careful with iodine intake. Pregnant women are more prone to hypothyroidism since the baby also intakes iodine through the mother’s food. Consult your doctor about the food and medicines to be avoided. Risk Factors of Hypothyroidism Myxedema coma Hypothyroidism can lead to an increase in the deposition of fat in the body, resulting in high cholesterol. When untreated, advanced hypothyroidism can cause myxedema coma. This condition is life-threatening and impairs total body functions. Pregnancy complications Hypothyroidism can cause problems during pregnancy, including miscarriage, high blood pressure, slowing down the baby’s growth, and premature baby birth. Possible Complications of Hypothyroidism The possible complications of hypothyroidism, if left untreated, are: Myxedema coma (Life-threatening condition) Asthma and other breathing complications Depression (Affects the mental health) Inability to tolerate cold temperature Decreased functioning of the heart (Fat deposition and high cholesterol) Goitre (swelling of the thyroid gland) High blood pressure during pregnancy Premature delivery Miscarriage Slowing down the baby’s growth Hypothyroidism Prevention Hypothyroidism can’t be prevented, but extra care to be taken during the following conditions: Pregnancy Other autoimmune disorder Family history of thyroid-related disorders Radiation treatment to the neck or head to cure some other health conditions Medications which can affect normal thyroid functioning. Epidemiology of Hypothyroidism The estimated incidence of hypothyroidism is high in women compared to men. Hypothyroidism is highly prevalent in middle-aged people and pregnant women. Expected Prognosis of Hypothyroidism Fortunately, recent advancements in diagnostic procedures, treatment options, and medication have drastically reduced the number of new cases of hypothyroidism and its associated complications. Natural Progression of Hypothyroidism Hypothyroidism doesn’t spread to other organs of the body. However, not undergoing treatment may affect the normal thyroid and body functions. Pathophysiology of Hypothyroidism Hypothyroidism is characterised by the reduction in the secretion of the thyroid by the thyroid glands. It can also be identified by the swollen thyroid gland located below the vocal cord on both sides. Related Blogs Women Health: Super Foods Every Woman Must Include in Diet Major Constipation Causes Everyone Should Be Aware Of Everything You Need to Know About High Cholesterol

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Pheochromocytoma is a tumor that develops in the medulla of the adrenal gland (the inner part of the adrenal gland). Adrenaline (epinephrine) and noradrenaline are produced by the adrenal medulla (norepinephrine). A tumor in this location can cause an excess of these hormones. Thus, it causing incredibly high blood pressure. It occurs most frequent in individuals between 30 and 50, although it can affect anyone of any age. Children account for around 10% of all instances. About 10% to 15% of these tumors are malignant, and they have the potential to spread to other regions of your body. However, most pheochromocytoma tumors are benign, which means they aren't malignant. It is essential to identify this issue as soon as possible. It may cure high blood pressure by locating and treating it. If not addressed, it can cause a heart attack, a stroke, and impaired artery function. Pheochromocytoma Causes People who inherit Pheochromocytoma from their parents may acquire genetic disorders related to it. These are some of the conditions: Von Hippel-Lindau disease is a non-cancerous disorder in which cysts and tumors form in the central nervous system, kidneys, adrenal glands, and other body parts. Type 1 neurofibromatosis is characterized by the growth of tumors on the skin and optic nerves. Pheochromocytoma is associated with multiple endocrine neoplasia type 2 (MEN2), a thyroid cancer. Pheochromocytoma Symptoms Pheochromocytoma can cause severe symptoms in some people but not in others because it depends upon disease stage and varies from person to person. Symptoms might appear numerous times per day to a few times each month. Some of the signs and symptoms include: Dizziness Racing heartbeat Anxiety Shortness of breath Constipation High blood pressure Weakness Fatigue Severe headache Pale skin Vomiting Stomach pain Tremors Excessive sweating Pheochromocytoma Diagnosis and Test Lab Tests If they have pheochromocytoma symptoms, the doctor will request urine and blood tests to examine your hormone levels. 24-hour urine testing to detect hormone levels and biochemical analysis to test plasma metanephrines. Imaging tests The doctor will use imaging tests such as CT, MRI, M-iodobenzylguanidine (MIBG) imaging, and Positron emission tomography (PET) to determine the location and size of the tumor. They'll look for symptoms that cancer has spread to other places of the body, as well. Epidemiology It is a rare disease. The majority of malignancies appear sporadically throughout the fourth and fifth decades. Pheochromocytoma affects less than one in every 100 persons with high blood pressure, and more than 95 percent of those instances aren't malignancy. Hereditary syndromes are closely connected to around 1/3 of the cases. According to estimations, 95% of patients diagnosed with a malignant type of pheochromocytoma that hasn't migrated to other regions of their body live for at least another five years. About 50 percent to 60 percent of malignancies that have spread or returned after therapy live for at least five years following diagnosis. Pheochromocytoma Treatment Medications Your doctor may prescribe medications to help you manage your symptoms, such as alpha and beta-blockers blood pressure medications. Surgery Surgery is utilized to remove the cancer/tumor as much as possible. It may lead to removing the entire adrenal gland in rare circumstances. Radiation therapy and chemotherapy When pheochromocytoma has spread to other body regions, radiation therapy and chemotherapy treatments are performed. Other treatments Include targeted cancer therapies, MIBG therapy, Peptide receptor radionuclide therapy (PRRT). Risk Factor of Pheochromocytoma Exact cause of this is not known. Pheochromocytoma and paraganglioma are both caused by some of the genetic abnormalities include: Von Hippel-Lindau syndrome (VHL). Neurofibromatosis type 1 (NF1) Carney triad (paraganglioma, GIST, and pulmonary chondroma) Hereditary paraganglioma syndrome Multiple endocrine neoplasia type 2 (MEN2) Succinate dehydrogenase (SDHx) syndromes. Carney-Stratakis dyad (paraganglioma and gastrointestinal stromal tumor [GIST]). Possible Complications of Pheochromocytoma The following list comprises of the possible complications of pheochromocytoma: Stroke Heart attack (Angina pectoris) The disease of the Heart muscle (Cardiomyopathy) Accumulation of fluid in lungs (Pulmonary edema) Kidney failure Optic Nerve damage Brain Hemorrhage Expected Prognosis of Pheochromocytoma Prognosis is a prediction of how a condition will affect you in the long term. Every person is unique, and the prognosis is influenced by a variety of circumstances, including: How much of the tumor was removed during surgery Where the tumor present is in your body If the disease has spread to other regions of your body Doctors calculate pheochromocytoma survival rates by looking at how previous pheochromocytoma patients fared. The five-year survival percentage for patients with a small pheochromocytoma that has not migrated to other regions of the body is around 95 percent. Whatever therapy they choose, they need to see the doctor regularly to ensure that pheochromocytoma doesn't resurface. They can also assist you in managing any treatment-related long-term adverse effects. Pathophysiology of Pheochromocytoma Excessive catecholamine production and subsequent activation of adrenergic receptors are found to cause pheochromocytoma. It emerges from the sympathetic ganglia and adrenal medulla's chromaffin cells. According to researchers, Pheochromocytoma is mainly caused by mutations in roughly 20 distinct genes. It can be caused by mutations in the genes RET, VHL, NF1, SDHA, SDHB, SDHC, SDHD, SDHAF2, MDH2, IDH1, PHD1/PHD2, HIF2A/EPAS1/2, TMEM127, MAX, HRAS, MAML3, and CSDE1. It can be grouped into three clusters of mutations based upon the function and regulation of genes.

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