Sympathoadrenal function in patients with paroxysmal hypertension: Pseudopheochromocytoma

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

  • Yehonatan Sharabi - , National Institutes of Health (NIH) (Autor:in)
  • David S. Goldstein - , National Institutes of Health (NIH) (Autor:in)
  • Oladi Bentho - , National Institutes of Health (NIH) (Autor:in)
  • Ahmed Saleem - , National Institutes of Health (NIH) (Autor:in)
  • Sandra Pechnik - , National Institutes of Health (NIH) (Autor:in)
  • Marilla F. Geraci - , National Institute of Mental Health (NIMH) (Autor:in)
  • Courtney Holmes - , National Institutes of Health (NIH) (Autor:in)
  • Karel Pacak - , Eunice Kennedy Shriver National Institute of Child Health and Human Development (Autor:in)
  • Graeme Eisenhofer - , Medizinische Klinik und Poliklinik III, Institut für Klinische Chemie und Laboratoriumsmedizin, National Institutes of Health (NIH) (Autor:in)

Abstract

OBJECTIVES: The causes of paroxysmal hypertension in patients in whom pheochromocytoma has been excluded ('pseudopheochromocytoma') usually remain unclear. Blood pressure disturbances and symptoms of catecholamine excess in these patients may reflect activation of the sympathetic nervous and adrenal medullary systems. We therefore examined sympathoadrenal function in patients with pseudopheochromocytoma compared with age-matched control subjects in whom there was no suspicion of pheochromocytoma. METHODS: Plasma catecholamines and hemodynamics were examined in response to intravenous glucagon, yohimbine, and trimethaphan in 11 patients with pseudopheochromocytoma and a comparison group of nine normotensive and five hypertensive volunteers. Adrenomedullary function was also assessed by abdominal F-fluorodopamine positron emission tomography and measurements of plasma metanephrine, the O-methylated metabolite of epinephrine. RESULTS: Compared with controls, patients with pseudopheochromocytoma had normal plasma concentrations of norepinephrine, but 120% higher (P < 0.05) baseline plasma concentrations of epinephrine, 80% higher (P < 0.01) baseline plasma concentrations of metanephrine, and sixfold larger (P < 0.05) increases in plasma epinephrine after glucagon. Adrenal F-fluorodopamine-derived radioactivity did not differ between groups. Compared with changes in plasma norepinephrine, falls in blood pressure after trimethaphan were 13-fold larger (P < 0.005) and increases in blood pressure after yohimbine were threefold larger (P < 0.01) in pseudopheochromocytoma patients than in controls. CONCLUSION: Patients with pseudopheochromocytoma exhibit a pattern of normal sympathetic noradrenergic outflow, adrenomedullary activation, and augmented blood pressure responses to changes in the sympathoneural release of norepinephrine.

Details

OriginalspracheEnglisch
Seiten (von - bis)2286-2295
Seitenumfang10
FachzeitschriftJournal of hypertension
Jahrgang25
Ausgabenummer11
PublikationsstatusVeröffentlicht - Nov. 2007
Peer-Review-StatusJa

Externe IDs

PubMed 17921824

Schlagworte

Schlagwörter

  • Adrenal medulla, Catecholamines, Hypertension, Metanephrines, Pheochromocytoma, Pseudopheochromocytoma, Sympathetic nervous system