{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T20:02:21Z","timestamp":1787169741421,"version":"build-2736575974"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>\n                    A\n                    <jats:sc>BSTRACT<\/jats:sc>\n                  <\/jats:title>\n                  <jats:p>Pheochromocytoma is a rare neuroendocrine tumor presenting with a classical triad of symptoms. In 10% of the cases, the presentation can be atypical, and the diagnosis is often missed for several years. Most common neurological manifestations are haemorrhage, seizures, etc., but pheochromocytoma crisis presenting as delirium has been infrequently reported. We present a case of a middle-aged female who presented with hypertensive emergency and an acute confusional state. Other causes of delirium were ruled out in the patient and a timely diagnosis of pheochromocytoma was made with CT abdomen showed a large right suprarenal mass which was confirmed on 123I-MIBG scan and supported by elevated plasma metanephrines. She responded to alpha and beta blockers following which her blood pressure spikes were controlled, and subsequently, her sensorium improved significantly. Patient underwent surgical resection of the tumor and was followed up after 2 weeks with her blood pressure controlled without any medications.<\/jats:p>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>A high degree of clinical suspicion is essential in such rare presentations of pheochromocytoma. Early diagnosis, adequate preoperative preoperative stabilization followed by a definitive surgical excision offers a complete cure to such patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jfmpc.jfmpc_1619_22","type":"journal-article","created":{"date-parts":[[2023,3,23]],"date-time":"2023-03-23T04:03:11Z","timestamp":1679544191000},"page":"586-589","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["An atypical manifestation of pheochromocytoma crisis: Acute delirium"],"prefix":"10.4103","volume":"12","author":[{"given":"Mayank","family":"Agarwal","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravi","family":"Kant","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shridhar","family":"Pattar","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,3,17]]},"reference":[{"key":"R1-20240828","first-page":"802","article-title":"Occurrence of pheochromocytoma in Rochester, Minnesota, 1950 through 1979","volume":"58","author":"Beard","year":"1983","journal-title":"Mayo Clin Proc"},{"key":"R2-20240828","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1016\/j.jamcollsurg.2009.09.022","article-title":"Clinical spectrum of pheochromocytoma","volume":"209","author":"Guerrero","year":"2009","journal-title":"J Am Coll Surg"},{"key":"R3-20240828","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1007\/s11910-021-01105-2","article-title":"Neurological complications of endocrine emergencies","volume":"21","author":"Cruz-Flores","year":"2021","journal-title":"Curr Neurol Neurosci Rep"},{"key":"R4-20240828","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1097\/00005792-199101000-00004","article-title":"A simplified diagnostic approach to pheochromocytoma. A review of the literature and report of one institution's experience","volume":"70","author":"Stein","year":"1991","journal-title":"Medicine (Baltimore)"},{"key":"R5-20240828","first-page":"20","article-title":"Catecholamine-induced cerebral vasospasm and multifocal infarctions in pheochromocytoma","volume":"2020","author":"Madhok","year":"2020","journal-title":"Endocrinol Diabetes Metab Case Rep"},{"key":"R6-20240828","first-page":"1","article-title":"Pheochromocytoma, \u201cthe great masquerader,\u201dpresenting as severe acute decompensated heart failure in a young patient","volume":"2018","author":"Reyes","year":"2018","journal-title":"Case Rep Cardiol"},{"key":"R7-20240828","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1136\/jnnp-2012-303028","article-title":"Neurological manifestations of and secretory paragangliomas:A reappraisal","volume":"84","author":"Anderson","year":"2013","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"R8-20240828","doi-asserted-by":"crossref","first-page":"2313","DOI":"10.1007\/s40618-022-01868-6","article-title":"Clinical characteristics and outcomes of pheochromocytoma crisis:A literature review of 200 cases","volume":"45","author":"Ando","year":"2022","journal-title":"J Endocrinol Invest"},{"key":"R9-20240828","doi-asserted-by":"crossref","first-page":"2313","DOI":"10.1007\/s40618-022-01868-6","article-title":"Clinical characteristics and outcomes of pheochromocytoma crisis:A literature review of 200 cases","volume":"45","author":"Ando","year":"2022","journal-title":"J Endocrinol Invest"},{"key":"R10-20240828","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1016\/j.aace.2021.03.008","article-title":"Pheochromocytoma crisis presenting with ARDS successfully treated with ECMO-assisted adrenalectomy","volume":"7","author":"Choudhary","year":"2021","journal-title":"AACE Clin Case Rep"},{"key":"R11-20240828","first-page":"20","article-title":"Pheochromocytoma crisis with cyclic fluctuation in blood pressure mimics acute coronary syndrome","volume":"2020","author":"Kometani","year":"2020","journal-title":"Endocrinol Diabetes Metab Case Rep"},{"issue":"(Suppl 1)","key":"R12-20240828","doi-asserted-by":"crossref","first-page":"S323","DOI":"10.1016\/j.mjafi.2020.03.018","article-title":"Pheochromocytoma with an unusual presentation","volume":"78","author":"Goel","year":"2022","journal-title":"Med J Armed Forces India"}],"container-title":["Journal of Family Medicine and Primary Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jfmpc.jfmpc_1619_22","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:11:27Z","timestamp":1787166687000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jfmpc.jfmpc_1619_22"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3]]},"references-count":12,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.4103\/jfmpc.jfmpc_1619_22","relation":{},"ISSN":["2249-4863","2278-7135"],"issn-type":[{"value":"2249-4863","type":"print"},{"value":"2278-7135","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3]]},"assertion":[{"value":"2022-08-14","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-01-02","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}