A New Concept of Unopposed β-Adrenergic Overstimulation in a Patient with Pheochromocytoma
Authors: Vitaly Kantorovich
Journal: Annals of Internal Medicine (2005)

Letters21 June 2005A New Concept of Unopposed β-Adrenergic Overstimulation in a Patient with PheochromocytomaVitaly Kantorovich, MD and Karel Pacak, MD, PhD, DScVitaly Kantorovich, MDFrom the National Institutes of Health, Bethesda, MD 20892.Search for more papers by this author and Karel Pacak, MD, PhD, DScFrom the National Institutes of Health, Bethesda, MD 20892.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-142-12_Part_1-200506210-00023 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Background: The concept of unopposed β-adrenergic overstimulation during selective α-adrenergic blockade in patients with pheochromocytoma is well recognized (1-4). We present a case that suggests the existence of an opposite phenomenon: a syndrome of unopposed β-adrenergic overstimulation.Case Report: A 46-year-old woman with multiple endocrine neoplasia type 2A was admitted to the endocrine ward of the National Institutes of Health Warren Grant Magnuson Clinical Center. On a previous admission, she had reported progressive spells of headaches, paleness, and palpitations and was found to have bilateral adrenal pheochromocytomas (right side, 4.7 × 3.1 cm; left side, 2.0 × ...References1. Sloand EM, Thompson BT. Propranolol-induced pulmonary edema and shock in a patient with pheochromocytoma. Arch Intern Med. 1984;144:173-4. [PMID: 6691755] CrossrefMedlineGoogle Scholar2. Manger WM, Gifford RW. Pheochromocytoma. J Clin Hypertens (Greenwich). 2002;4:62-72. [PMID: 11821644] CrossrefMedlineGoogle Scholar3. Pacak K, Linehan WM, Eisenhofer G, Walther MM, Goldstein DS. Recent advances in genetics, diagnosis, localization, and treatment of pheochromocytoma. Ann Intern Med. 2001;134:315-29. [PMID: 11182843] LinkGoogle Scholar4. Bravo EL. Pheochromocytoma: an approach to antihypertensive management. Ann N Y Acad Sci. 2002;970:1-10. [PMID: 12381537] CrossrefMedlineGoogle Scholar5. Tsujimoto G, Manger WM, Hoffman BB. Desensitization of beta-adrenergic receptors by pheochromocytoma. Endocrinology. 1984;114:1272-8. [PMID: 6323140] CrossrefMedlineGoogle Scholar6. Cases A, Bono M, Gaya J, Jimenez W, Calls J, Esforzado N, et al. Reversible decrease of surface beta 2-adrenoceptor number and response in lymphocytes of patients with pheochromocytoma. Clin Exp Hypertens. 1995;17:537-49. [PMID: 7613527] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From the National Institutes of Health, Bethesda, MD 20892.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoRecent Advances in Genetics, Diagnosis, Localization, and Treatment of Pheochromocytoma Moderator: Karel Pacak , Discussants: W. Marston Linehan , Graeme Eisenhofer , McClellan M. Walther , and David S. Goldstein Correction: A New Concept of Unopposed β-Adrenergic Overstimulation in a Patient with Pheochromocytoma Metrics Cited ByPathophysiology and Acute Management of Tachyarrhythmias in PheochromocytomaPersonalized diagnostics of chromaffin tumors (pheochromocytoma, paraganglioma) in oncoendocrinologyRadionuclide Imaging of Chromaffin Cell TumorsPheochromocytomaAnesthesia for PheochromocytomaPheochromocytoma and ParagangliomaEmergencies Caused by Pheochromocytoma, Neuroblastoma, or GanglioneuromaCorrection: A New Concept of Unopposed β-Adrenergic Overstimulation in a Patient with Pheochromocytoma 21 June 2005Volume 142, Issue 12_Part_1Page: 1026-1028KeywordsBlood pressureCatecholaminesEdemaHeart ratePheochromocytomaThyroxineUrineVasoconstrictionVital signs ePublished: 21 June 2005 Issue Published: 21 June 2005 CopyrightCopyright © 2005 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...