Pharmacologic and Chemical Tests as an Aid in the Diagnosis of Pheochromocytoma

Abstract

Today pharmacologic and chemical tests are helpful in screening a relatively large number of patients for pheochromocytoma and are a definite aid to a correct diagnosis. No one test is infallible, and knowledge concerning the drugs used or the manner in which the blood and urine are collected, or both, is necessary to avoid a false-positive or false-negative result from the tests.

URINARY EXCRETION OF NORADRENALINE AND ITS METABOLITES AT TEN-MINUTE INTERVALS AFTER INTRAVENOUS INJECTION OF dl-NORADRENALINE-2-C14*

“…Although an iv injection of noradrenaline cannot be extrapolated in the precise terms of the normal release of noradrenaline from the adrenergic nerve endings, there are nevertheless some distinct similarities. For example, these experiments could be closely correlated to the release of noradrenaline from a noradrenaline-producing pheochromocytoma, which, as is known, can release into the vascular system very large quantities of noradrenaline (15)(16)(17)(18)(19) (27) showed that after an infusion of noradrenaline in the human, only 1.5 to 3.3%o of the infused dose could be accounted for in the urine; from their experiments, it was inferred that normally some 0.5 to 1 % l-noradrenaline per minute reached the general circulation. Furthermore, it is well-known that with an infusion of noradrenaline, certain compensatory mechanisms come into play that depress the release of endogenous noradrenaline; this implies that at least some of the exogenous noradrenaline is handled like the endogenous.…”

Six Cases of Phaeochromocytoma with Unusual Clinical Manifestations

“…Intravenous phentolamine for patients with persistent hypertension, and histamine stimulation with subsequent phentolamine administration for those with a normal pressure, are useful screening tests (Roth, Flock, Kvale, Waugh, and Ogg, 1960). However, false-positive and false-negative results opccur in a variety of circumstances, and, moreover, the histamine provocation test may induce dangerously high blood-pressure.…”