Document Detail


Sympathoadrenal function in patients with paroxysmal hypertension: pseudopheochromocytoma.
MedLine Citation:
PMID:  17921824     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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 18F-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.
Authors:
Yehonatan Sharabi; David S Goldstein; Oladi Bentho; Ahmed Saleem; Sandra Pechnik; Marilla F Geraci; Courtney Holmes; Karel Pacak; Graeme Eisenhofer
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Intramural    
Journal Detail:
Title:  Journal of hypertension     Volume:  25     ISSN:  0263-6352     ISO Abbreviation:  J. Hypertens.     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-10-08     Completed Date:  2008-01-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  2286-95     Citation Subset:  IM    
Affiliation:
National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA.
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MeSH Terms
Descriptor/Qualifier:
Adrenal Glands / physiopathology*
Adult
Baroreflex
Blood Pressure Monitoring, Ambulatory
Epinephrine / blood
Female
Glucagon / pharmacology
Humans
Hypertension / physiopathology*
Isoproterenol / pharmacology
Male
Middle Aged
Norepinephrine / blood
Panic Disorder / etiology
Pheochromocytoma / physiopathology*
Positron-Emission Tomography
Sympathetic Nervous System / physiopathology*
Trimethaphan / pharmacology
Yohimbine / pharmacology
Chemical
Reg. No./Substance:
146-48-5/Yohimbine; 51-41-2/Norepinephrine; 51-43-4/Epinephrine; 7187-66-8/Trimethaphan; 7683-59-2/Isoproterenol; 9007-92-5/Glucagon
Comments/Corrections
Comment In:
J Hypertens. 2007 Nov;25(11):2204-6   [PMID:  17921812 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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