A 29-year-old woman was referred for chronic paroxysmal palpitations, flushing, a pale complexion, and diaphoresis. She reported increasing symptoms possibly affected by stress, left lateral recumbent position, and physical activity. There was no history of weight loss, hypertension, medication use, or a family history of genetic syndromes such as von Hippel-Lindau. Physical examination revealed a body mass index of 25.9, blood pressure of 112/74 mm Hg, and a heart rate of 82 beats/min without cardiac or renal artery murmurs or skin lesions. Laboratory tests were performed (Table 1).
Hannah-Shmouni F, Pacak K, Stratakis CA. Metanephrines for Evaluating Palpitations and Flushing. JAMA. 2017;318(4):385–386. doi:10.1001/jama.2017.5926
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