Seventy years of pheochromocytomas and paragangliomas in Argentina. The FRENAR database

Pheochromocytomas and paragangliomas (PPGL) are neuroendocrine tumors characterized by the excessive production of catecholamines. This study aims to describe the clinical characteristics of PPGL cases in Argentina over recent decades. A multicenter retrospective cross-sectional analysis was carried out using a database comprising both pediatric and adult patients with confirmed PPGL diagnoses based on pathological reports. A cohort of 486 patients with PPGL was recruited. Women represent 58.4% of the patients, with a mean age of 38.3 years old at the time of diagnosis and 15.2% of the patients were under the age of 18. Hypertension, as well as classic signs and symptoms, were present in 80.9% of the patients. The adrenal incidentaloma, as a mode of presentation, increased in the last two decades rising from 3.9% (1953-2000) to 21.8% (2001-2022), p<0.001. Most tumors were located within the adrenal glands, accounting 83.0% of the cases, with bilateral occurrences noted in 20.0%. The median tumor size was 4.8cm. Local recurrence and metastases were observed in 10.9% and 12.2%. Out of 412 patients, 87.0% exhibited urinary excretion elevation of catecholamines and/or their metabolites. Furthermore, 148 patients, representing 30.4% of the study population, displayed a distinct genetic profile indicative of hereditary syndromes. The distribution of hereditary syndromes revealed that MEN2, VHL, and PGL4 constituted the most prevalent syndromes. This population-based study, spanning seven decades, offers valuable insights into the demographic and clinical characteristics of PPGL patients in Argentina.

[Acute nephrotic syndrome associated with secondary syphilis]

We present a case of a 38 year old woman with nephrotic syndrome and skin rash. She had been previously healthy. At the beginning she showed nonpruritic macular papular lesion in trunk and upper and lower extremities with twenty days of evolution. The week previous to hospitalization, she presented eyelid and pretibial edema. The laboratory informed normal kidney function with proteinuria of 10 g/day, plasma proteins of 4.20 g/dl., cholesterol 334 mg/l, VDRL (+), 1/32 FTA abs (+) HIV non reactive, normal collagenogram. She was diagnosed as secondary syphilitic nephrotic syndrome. She was prescribed penicillin, rest and salt restriction. She presented good evolution before ending treatment and the syndrome was completely solved at the third week. The incidence of kidney condition associated with early staging of syphilis is lower than 0.3%. We call attention to this association, for such an uncommon case may not be detected.