Autonomic hyperactivity symptoms

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

#### Differentiating Hypoglycemia from other diseases that cause autonomic hyperactivity symptoms:

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Disease  | Clinical Manifestation  | Investigations

|
|

Symptoms  | Signs
Palpitations  | Fever  | Sweating  | Headache
Hypoglycemia | \+  | \-  | \+  | \+  |

* Tachycardia
* Blurred vision
* Pallor
* Tremors
* Seizures/ Coma

* Plasma glucose <70 mg/dL
* Serum Insulin level
* Serum Proinsulin
* Serum C-Peptide

Anxiety disorders | \+  | \-  | \+  | \+  |

* Patient looks irritable

* Rapid pulse and may be irregular

* Psychiatry evaluation

Pheochromocytoma[1][2] | \+  | \+  | \+  | \+  |

* Tachycardia

* Strong rapid pulse

* High pulse pressure

* Plasma fractionated metanephrines, 24-hour urinary fractionated metanephrines, catecholamines.
* Computed tomography: Radiological evaluation should follow lab tests to locate site of the tumorr.

Arrhythmia | \+  | \-  | \-  | \-  |

* Irregular pulse

* ECG changes according to the cause

Hyperthyroidism | \+  | \+  | \+  | \+  |

* Hyperactive deep tendon reflexes
* Thyromegaly
* Exophthalmus

* Level of thyroid-stimulating hormone (TSH)
* Levels of T4 and/or T3 in the blood
* Antibodies such as anti-TSH-receptor antibodies in Graves' disease

## References

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1. ↑ Lenders JW, Pacak K, Walther MM, Linehan WM, Mannelli M, Friberg P; et al. (2002). "Biochemical diagnosis of pheochromocytoma: which test is best?". JAMA. 287 (11): 1427–34. PMID 11903030.CS1 maint: Explicit use of et al. (link) CS1 maint: Multiple names: authors list (link)
2. ↑ Bravo EL (1991). "Pheochromocytoma: new concepts and future trends". Kidney Int. 40 (3): 544–56. PMID 1787652.