Miction-induced Hypertension Disclosed by Home Blood Pressure Measurement in a Patient with Small Paraganglioma

• Published in: Internal Medicine Vol. 59; no. 6; pp. 793 - 797
• Main Authors: Teragaki, Masakazu, Yamamoto, Takayuki, Hosomi, Kota, Tada, Youhei, Maeda, Keiko, Nishiya, Daisuke, Miyazaki, Chinami, Takagi, Yasuhiro, Sakanoue, Yuji, Nishida, Yukio, Okuno, Hiroshi, Tsuiki, Mika, Naruse, Mitsuhide
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 15.03.2020; Japan Science and Technology Agency
• Subjects: Blood pressure; Case Report; catecholamine; Catecholamines; Headache; Hypertension; hypertensive crisis; Internal medicine; Nausea; Paraganglioma; Pheochromocytoma; postmiction syndrome; Scintigraphy; secondary hypertension; Urinary bladder; urinary bladder tumor; catecholamine; postmiction syndrome; urinary bladder tumor; secondary hypertension; hypertensive crisis
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.3255-19

A 46-year-old woman complained of a 10-year history of headache, nausea, a precordial oppressive feeling and shortness of breath on miction. She had noted a marked elevation in her blood pressure after miction using home blood pressure measurement. Her catecholamine levels were less than twice the value of the normal upper limit. Several imaging modalities detected a urinary bladder tumor, and 123I-metaiodobenzylguanidine scintigraphy showed positive accumulation. The diagnosis of urinary bladder paraganglioma was confirmed by partial cystectomy. We must keep in mind that paroxysms and hypertension associated with miction are important diagnostic clues of pheochromocytoma/paraganglioma. Home blood pressure measurement was very useful for detecting hypertension in this case.