Uniting against pheochromocytoma

UST Hospital has been named the first Southeast Asian partner of the United States’ National Institutes of Health (NIH) in fighting sustained hypertension caused by pheochromocytoma — a rare and fatal neuroendocrine disease that affects mostly children and young adults — because of the hospital’s pioneering work against the disease.

Thomasian doctors from the hospital’s endocrinology and metabolism section were cited by the NIH’s National Institute of Child Health and Child Development for their “revolutionary” methods, which involve invasive and direct blood and organ sampling from the adrenal glands.

The collaborative research program includes free genetic blood testing and extraction at the hospital of patients diagnosed with pheochromocytoma. Samples will be sent to the NIH, the US federal agency that provides guidelines on the causes, prevention, and treatment of common and rare diseases.

Adrenaline crash

Pheochromocytoma is a tumor that causes irregularities and oversecretion of hormones in the adrenal gland, a star-shaped organ that sits on top of the kidneys and produces stress-regulating chemicals such as adrenaline.

According to Dr. Leilani Mercado-Asis, head of the UST Hospital’s section of endocrinology and metabolism, symptoms of pheochromocytoma include headaches, sweating, quick pounding of the heart, pain in the chest, drastic weight loss, and a feeling of anxiety.

“If a patient has these symptoms, administration of a blood or urine test should be done to see if there are extra hormones in the body (which is a reason for) the patient to be suspected of having the disease,” Asis told the Varsitarian.

People with pheochromocytoma experience extremely high blood pressure and may hit anyone, at any age, she added.

“The youngest patient we have had at the UST Hospital was 15 years old. She had a blood pressure of 140/190, and was positive for pheochromocytoma,” she said. “This (disease) is sustained hypertension, which, if uncontrolled, can lead to stroke, heart attack or even death.”

Early signs of hypertension may be detected when the blood pressure ranges from 120 to 139 over 80 to 89. Also, a blood pressure of 260/160 is an indication of pheochromocytoma, she said.

With pheochromocytoma affecting only a tenth of one percent of Filipinos, it was initially thought of as a disease capable of affecting only people aged 50 to 60 years old and above.

But recent findings reveal that the usual suspects’ ages range from 20 to 30 years old.

“It is possible that that the prevalence (of pheochromocytoma) is greater in our country. Maybe doctors, who knew little about this disease, simply attributed the patients’ symptoms to hypertension; hence, not much is reported about this,” Asis said.

Thomasian edge

Another benefit of the collaborative effort is the opportunity for Filipino physicians to train in the NIH, considered the mecca of medical research and clinical studies.

“Our groundbreaking partnership with the NIH provides an opportunity to complement the world-class training that our doctors undergo here in our country,” Asis said last Jan. 21 during the UST Hospital’s press conference at Annabel’s restaurant in Quezon City.

UST Hospital’s section of endocrinology and metabolism is the first Philippine-based endocrine training program to tie up with the NIH for residence training.

According to Dr. Jeremy Robles, chief fellow of the endocrinology and metabolism section, the UST-NIH program involves two-and-a-half years of training in UST and the NIH in Maryland.

“The first two years of fellowship training program will be at the UST Hospital. Following that is a six-month training at NIH and a mentorship with Dr. Karel Pacak,” Robles said, referring to the head of the NIH’s National Institute of Child Health and Child Development.

Pacak, president of the first international symposium on pheochromocytoma, spearheaded the partnership between UST and NIH when he became a visiting professor in UST last year.

Every year, three fellows from the UST Hospital will be allowed to study and conduct researches at the NIH for free. Fellows will be chosen based on their credentials and performance during their two-year training program at the UST Hospital.

“This study will give an opportunity for our countrymen to be worked up for a costly disease, and allow us to formulate Asian data on this particular disorder,” Asis said. “Moreover, this tie-up will greatly benefit UST’s medical students because they will get first-hand research information from their mentors.”