Clinical and Biochemical Aspects of Pheochromocytoma

Januszewicz, W; Wocial, B

doi:10.1159/000173959

Cited by 30 publications

(9 citation statements)

References 6 publications

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“…However, all patients with pheochromocytoma, regardless of their blood pessure patterns, had urinary TM values above 5485 nmol/day as NM (1000 /xg/24 h), well above the upper limit of normal. Thus, this study reaffirms the usefulness of determining urinary TM in the diagnosis of pheochromocytoma (1,2,(16)(17)(18). Remine et al (19) reported that 96% of pheochromocytoma patients could be diagnosed by the determination of urinary TM, 79% could be diagnosed by the determination of urinary CA, and only 53% could be diagnosed by the determination of plasma CA.…”

Section: Discussionsupporting

confidence: 80%

Urinary Normetanephrine and Metanephrine Measured by Radioimmunoassay for the Diagnosis of Pheochromocytoma: Utility of 24-Hour and Random 1-Hour Urine Determinations

Oishi

Sato

Masato

et al. 1988

The Journal of Clinical Endocrinology & Metabolism

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To validate the clinical usefulness of recently developed normetanephrine (NM) and metanephrine (M) RIA for the diagnosis of pheochromocytoma, urinary excretion of catecholamines and these metabolites were determined in 30 normal subjects, 40 patients with essential hypertension, 30 patients who were suspected to have but ultimately proven not to have a pheochromocytoma (pheochromocytoma-suspect), and 31 patients with a surgically verified pheochromocytoma. Abnormally high catecholamine excretion (epinephrine plus norepinephrine) was found in patients with pheochromocytoma compared with that in the normal subjects and the essential hypertension group. However, 3 of 31 patients with pheochromocytoma had urinary catecholamine excretion that overlapped the values in the pheochromocytoma-suspect group. Both urinary NM and M excretion also were elevated in patients with pheochromocytoma, but in 4 of 31 patients with pheochromocytoma urinary M excretion was within the range found in 1 or more of the other groups. Total M (NM plus M) excretion of more than 5485 nmol/day (as NM) was found in all patients with pheochromocytoma, and all patients had values that were higher than the highest values in the normal subjects or the patients with no evidence of pheochromocytoma. To save time and simplify the diagnostic work-up of patients suspected of having a pheochromocytoma, we also determined the NM and M concentrations in randomly voided 1-h urine samples in 24 patients with pheochromocytomas, 31 patients with essential hypertension, and 16 normal subjects. Abnormally high total M excretion was found in all patients with pheochromocytomas, and there was no overlap with the values in the patients with essential hypertension or the normal subjects. We conclude that total M measurements in both 24-h and random 1-h urine samples are useful in diagnosing pheochromocytomas. (J Clin Endocrinol Metab 67: 614,1988) P HEOCHROMOCYTOMA is a tumor characterized by an excessive production of catecholamines, and it is one of the surgically curable causes of hypertension. During the last 20 yr, the generally accepted tests for the diagnosis of pheochromocytoma have been measurements of catecholamines [epinephrine (E) and norepinephrine (NE)] and their metabolites, normetanephrine (NM), metanephrine (M), and 4-hydroxy-3-methoxymandelic acid (VMA), in 24-h urine collections (1-4). However, such measurements are time-consuming and sometimes impossible, particularly in out-patient clinics and hypertensive emergency patients. Recently, it was suggested that measurement of these compounds in overnight (5, 6) or single voided urine (7) samples was adequate for separating patients with pheochromocytoma from those with other types of hypertension. However, data on the excretion of catecholamine metabolites during normotension in patients with paroxysmal hypertension due to a pheochromocytoma are not available. In this study we examined the clinicial value of measurements of the catecholamine metabolites NM and M using recently developed RIAs (8)...

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Section: Discussionsupporting

confidence: 80%

Urinary Normetanephrine and Metanephrine Measured by Radioimmunoassay for the Diagnosis of Pheochromocytoma: Utility of 24-Hour and Random 1-Hour Urine Determinations

Oishi

Sato

Masato

et al. 1988

The Journal of Clinical Endocrinology & Metabolism

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“…In rare instances, pheochromocytoma causes sudden peripheral ischemia, resulting in necrosis or gangrene [74][75][76][77]. In most cases, this ischemia is due to extreme vasoconstriction or diffuse arterial vasospasms induced by catecholamine overload.…”

Section: Acute Peripheral Ischemiamentioning

confidence: 99%

“…Patients may also present with intestinal pseudo-obstruction [92,93], abdominal distension [94], severe paralytic ileus [74,89,95,96], dilated small bowel loops [97], or megacolon [94,98]. The latter may be complicated by enterocolitis [98,99], volvulus or colonic rupture [100], and fecal peritonitis [101].…”

Section: Gastrointestinal Emergenciesmentioning

confidence: 99%

Emergencies Caused by Pheochromocytoma, Neuroblastoma, or Ganglioneuroma

Brouwers

Eisenhofer

Lenders

et al. 2006

Endocrinology and Metabolism Clinics of North America

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This article reviews emergency situations caused by diseases of the sympathetic nervous system. Pheochromocytoma is discussed first and most extensively, because there are numerous reports in the literature on patients with (unsuspected) pheochromocytoma presenting as an emergency. Two other tumors of the sympathetic nervous system are then discussed that less commonly result in endocrine emergencies: neuroblastoma and ganglioneuroma. PheochromocytomaParagangliomas are rare catecholamine-producing tumors derived from chromaffin cells that can be fatal if left undiagnosed.

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“…Pheochromocytomas are relatively uncommon in children, but sometimes can be incidentally observed, especially in adolescents with hypertension. A calcified pheochromocytoma has been described in single case reports 9 .…”

Section: Discussionmentioning

confidence: 99%

Incidental Finding of Idiopathic Unilateral Adrenal Calcification in an 18-Month-Old Child: Case Report and Review of the Literature

Puma

Rigante

Stabile

et al. 2010

Journal of Pediatric Endocrinology and Metabolism

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The presence of calcified lesions in the adrenal gland requires a careful endocrine, microbiological and radiological evaluation combined with detailed clinical history to confirm its non-evolving nature and avoid unnecessary surgery. We report an 18-monthold male child hospitalized with an incidentally discovered calcification in his right adrenal gland. All biochemical data as well as liver, renal and adrenal function tests were normal. Abdominal computed tomography scan showed that the right adrenal gland was completely occupied by a large calcification, which was put in relationship with an undetected adrenal distress during the neonatal period, as macrosomy and clavicle fracture of the newborn could let us suggest. Our report describes the diagnostic approach to disclose the nature of a suprarenal mass, which is particularly problematic when this is found incidentally. In addition, an extensive review of the medical literature dealing with non-traumatic adrenal calcifications and haemorrhages in children has been carried out.

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Clinical and Biochemical Aspects of Pheochromocytoma

Cited by 30 publications

References 6 publications

Urinary Normetanephrine and Metanephrine Measured by Radioimmunoassay for the Diagnosis of Pheochromocytoma: Utility of 24-Hour and Random 1-Hour Urine Determinations

Urinary Normetanephrine and Metanephrine Measured by Radioimmunoassay for the Diagnosis of Pheochromocytoma: Utility of 24-Hour and Random 1-Hour Urine Determinations

Emergencies Caused by Pheochromocytoma, Neuroblastoma, or Ganglioneuroma

Incidental Finding of Idiopathic Unilateral Adrenal Calcification in an 18-Month-Old Child: Case Report and Review of the Literature

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