Searching for Pheochromocytoma: A New and Better Test?
Authors: Lawrence R. Krakoff
Journal: Annals of Internal Medicine (1995)

Editorials15 July 1995Searching for Pheochromocytoma: A New and Better Test?Lawrence R. Krakoff, MDLawrence R. Krakoff, MDEnglewood Hospital and Medical Center, Englewood NJ 07631Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-123-2-199507150-00011 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Pheochromocytoma. The term calls to mind fundamental problems in clinical medicine, such as secondary hypertension, screening for rare but dangerous diseases, management of high-risk patients, and short-hand mnemonics for “Board” questions (for example, the Rule of 10). To the medical student and resident, pheochromocytoma is a rare cause of secondary hypertension, a “zebra” whose hoofbeats are almost never heard among the herd of ordinary patients with hypertension encountered in the medical clinic or in-patient services. The specialist often deals with pheochromocytoma after a diagnosis is made elsewhere by a discerning or lucky physician (serendipity still helps us in this regard).... References1. Lenders JW, Keiser HR, Goldstein DS, Willemsen JJ, Friberg J, Jacobs MC, et al. Plasma metanephrines in the diagnosis of pheochromocytoma. Ann Intern Med. 1995; 123:101-9. Google Scholar2. Bravo EL, Gifford RW Jr. Current concepts. Pheochromocytoma: diagnosis, localization and management. N Engl J Med. 1984; 311:1298-303. Google Scholar3. Krakoff LR, Garbowit D. Adreno-medullary hypertension: a review of syndromes, pathophysiology, diagnosis, and treatment. Clin Chem. 1991; 37:1849-53. Google Scholar4. Duncan MW, Compton P, Lazarus L, Smythe GA. Measurement of norepinephrine and 3,4-dihydroxyphenylglycol in urine and plasma for the diagnosis of pheochromocytoma. N Engl J Med. 1988; 319:136-42. Google Scholar5. Krakoff LR. Management of the Hypertensive Patient. New York: Churchill Livingstone; 1995:79. Google Scholar6. Marini M, Fathi M, Vallotton M. (Determination of serum metanephrines in the diagnosis of pheochromocytoma.) Ann Endocrinol (Paris). 1995; 54:337-42. Google Scholar7. Cohn JN, Levine TB, Olivari MT, Garberg V, Lura D, Francis GS, et al. Plasma norepinephrine as a guide to prognosis in patients with chronic congestive heart failure. N Engl J Med. 1984; 311:819-23. Google Scholar8. Wilkenfeld C, Cohen M, Lansman SL, Courtney M, Dische MR, Pertsemlidis D, et al. Heart transplantation for end-stage cardiomyopathy caused by an occult pheochromocytoma. J Heart Lung Transpl. 1992; 11:363-6. Google Scholar9. Joint National Committee on Detection and Treatment of Hypertension. The 5th report of the Joint National Committee on Detection, Evaluation and Treatment of High Blood Pressure (JNCV). Arch Intern Med. 1993; 153:154-83. Google Scholar10. Fogarty J, Engel CC Jr, Russo J, Simon G, Katon W. Hypertension and pheochromocytoma testing. Arch Fam Med. 1994; 3:55-60. Google Scholar11. Gallen IW, Taylor RS, Salzmann MB, Tooke JE. Twenty-four hour ambulatory blood pressure and heart rate in a patient with a predominantly adrenaline secreting phaeochromocytoma. Postgrad Med J. 1994; 70:589-91. Google Scholar12. Grossman E, Goldstein DS, Hoffman A, Keiser HR. Glucogan and clonidine testing in the diagnosis of pheochromocytoma. Hypertension. 1991; 17:733-41. Google Scholar13. Pauker SG, Kopelman RI. Interpreting hoofbeats: can Bayes help clear the haze? N Engl J Med. 1992; 327:1009-13. Google Scholar Author, Article, and Disclosure InformationAffiliations: Englewood Hospital and Medical Center, Englewood NJ 07631Corresponding Author: Lawrence Krakoff, MD, Englewood Hospital and Medical Center, 350 Engle Street, Englewood NJ 07631. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPlasma Metanephrines in the Diagnosis of Pheochromocytoma Jacques W. M. Lenders , Harry R. Keiser , David S. Goldstein , Jacques J. Willemsen , Peter Friberg , Marie-Cecile Jacobs , Peter W. C. Kloppenborg , Theo Thien , and Graeme Eisenhofer Metrics Cited By1,111 Patients with Adrenal Incidentalomas Observed at a Single Endocrinological Center: Incidence of Chromaffin TumorsRecurrent Near-syncope with FlushingIn Reply 15 July 1995Volume 123, Issue 2Page: 150-151KeywordsAttentionBlood plasmaCatecholaminesExcretionHeart diseasesHeart failureHypertensionPheochromocytomaSecondary hypertensionSpecificity Issue Published: 15 July 1995 CopyrightCopyright © 1995 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...