Obese and hypertensive elderly patient, with incipient diabetic nephropathy and previous cardiovascular event, long-term treated with secretagogues

We report the case of a 75-year old patient affected by type 2 diabetes for about 20 years, treated for a prolonged period with insulin secretagogues. He is also affected by arterial hypertension, obesity and incipient diabetic nephropathy and had suffered a cardiovascular event. He was referred to us by his GP to verify his high values of glycated hemoglobin (HbA1c) and for an excessive weight increase (Diabetology)

Recurrent Urosepsis and Cardiogenic Shock in an Elderly Patient with Pheochromocytoma

Pheochromocytomas are thought to be uncommon in the elderly. However, the prevalence is likely to be higher than reported, as older patients are less likely to be diagnosed due to absence of classical symptoms of sympathetic overactivity and confounding effects of aging, comorbidities, and medications. We describe a hypertensive elderly patient with incidentally diagnosed pheochromocytoma complicated by recurrent urosepsis, cardiomyopathy, and fatal myocardial infarction. Our case demonstrates that, in older hypertensive patients without classical symptoms, orthostatic hypotension and urinary retention, which are common in the elderly, may indicate catecholamine excess and that the deleterious cardiovascular consequences of catecholamine excess in the elderly are not prevented by pharmacological α- and β-blockade.