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Phaeochromocytoma — RACP Paediatrics MCQ

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HardNephrologyPhaeochromocytomaRACP Paediatrics

A 10-year-old presents with episodic severe headaches, palpitations, sweating, and pallor. During an episode, blood pressure is 200/120 mmHg. 24-hour urinary catecholamines and metanephrines are markedly elevated. What is the most likely cause?

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Correct answer: D — Phaeochromocytoma

Episodic hypertension with paroxysmal symptoms of catecholamine excess (headaches, palpitations, sweating, pallor) and elevated urinary catecholamines/metanephrines is diagnostic of phaeochromocytoma. CT/MRI of the adrenal glands and MIBG scan are used for localisation. Alpha-blockade (phenoxybenzamine) must be established before any beta-blockade or surgery.

Reference: RACP Paediatric Curriculum – Endocrine/Nephrology; RCH Melbourne – 2023 – Hypertension CPG