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A 73-year-old woman with no remarkable medical history was admitted to our institution because of a 4-week course of recurrent episodes of dizziness, uncontrolled hypertension, and weight loss. Crises were stereotypical, beginning with headache, hot flush, profuse sweating, and quadriparesthesia followed by an increase in blood pressure and spontaneous resolution after 5 to 10 minutes. The results of a clinical examination after the episodes had subsided were normal. Suspicion of pheochromocytoma was supported by a large increase in norepinephrine levels in both serum and urine samples (serum norepinephrine, 14479 nmol/L [normal range, 1182-1773 nmol/L]; urinary norepinephrine, 1217.5 µmol per gram of creatinine [normal range, <532 µmol per gram of creatinine] [for 1 day]; urinary normetanephrine, 15937 µmol per gram of creatinine [normal range, <4200 µmol per gram of creatinine] [for 1 day]). There was no significant increase in either serum epinephrine or serotonin levels or urinary metanephrine and 5-hydroxyindoleacetic acid . . . [Full Text of this Article]

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