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March 24, 1951


Author Affiliations

Boston; Baltimore

From the Medical Clinic, the Johns Hopkins University and Hospital.

JAMA. 1951;145(12):880-884. doi:10.1001/jama.1951.02920300020004

Since Pincoffs and Shipley first successfully diagnosed and removed a pheochromocytoma 20 years ago,1 the search for this uncommon but usually curable cause of hypertension has received considerable attention. With the accumulation of a series of reported proved cases which now reaches over 100, a variety of clinical patterns has been recognized.

In our experience, reproducible symptomatic attacks associated with transient hypertension are still the outstanding manifestations of this disease and should always lead one to suspect its presence. Nine of the 12 patients whom we have seen at the Johns Hopkins Hospital and in neighboring institutions either complained primarily of such attacks or experienced them during observation in the ward. Although the manifestations and their severity varied considerably from patient to patient, the attacks followed the same pattern in each case. In all instances the paroxysmal hypertension was associated with anxiety, headache and precordial and epigastric distress. Most