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Uncontrolled hypertension: hints from the skin
  1. Jinson Paul1,
  2. Sudarsanababu Lalitha Soumya1,
  3. Cijoy Kuriakose1,
  4. Kripa Elizabeth Cherian1,
  5. Nitin Kapoor1,
  6. Thomas Vizhalil Paul2
  1. 1 Endocrinology, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India
  2. 2 Department of Endocrinology, Diabetes & Metabolism, Christian Medical College, Vellore, Tamil Nadu, India
  1. Correspondence to Dr Thomas Vizhalil Paul, Department of Endocrinology, Diabetes & Metabolism, Christian Medical College, Vellore, Tamil Nadu 632004, India; thomasvpaul{at}yahoo.com

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Case presentation

A 59-year-old woman presented with 4 months history of paroxysmal episodes of palpitations and headache. She was recently detected to have hypertension and was on two antihypertensive medications. Her blood pressure (BP) at presentation was 160/110 mm Hg and optic fundus showed grade 2 hypertensive retinopathy. She had features of neurofibromatosis-1 (NF-1) (figure 1 showing multiple neurofibromatoses on the posterior aspect of the trunk and figure 2 showing café-au-lait macules on forearm). In view of uncontrolled hypertension and findings of NF and café-au-lait macules, a possibility of an underlying phaeochromocytoma was considered. Venous sampling was done to assess renal function, serum electrolytes and metabolic profile. The results of these tests …

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