Pseudopheochromocytoma and Cardiac Arrest Associated With Phenylpropanolamine

THE SYMPATHOMIMETIC compound phenylpropanolamine hydrochloride is found in a variety of easily accessible medications including decongestants, anorectics, and stimulants. Serious complications associated with the use of phenylpropanolamine have been described, including hypertension,1-4 headaches,1-4 psychosis,5,6 seizures,1,2 and fatal cerebrovascular accidents.3 We recently cared for a 16-year-old girl with a history of recurrent episodes of paroxysmal hypertension and seizures in whom two episodes of cardiac arrest occurred. Her clinical constellation prompted a lengthy and expensive evaluation for pheochromocytoma before surreptitious ingestion of phenylpropanolamine was discovered. Increasing use of phenylpropanolamine-containing medications may make these complications more frequent.Report of a CaseA 16-year-old girl was hospitalized for evaluation of paroxysmal hypertension. Four months prior to admission she noted the onset of intermittent episodes of headache, diaphoresis, nausea, pallor, abdominal pain, nervousness, and fatigue. These episodes continued until the day of admission, when she was witnessed having a brief