PHEOCHROMOCYTOMA WITH PREDOMINANT EPINEPHRINE SECRETION

The clinical history and hospital course of a patient with pheochromocytoma are presented. Urine and tumor catecholamine levels were elevated and showed a predominance of epinephrine secretion over that of norepinephrine. The clinical picture usually seen in pheochromocytoma is recognized to be a blend of alpha and beta adrenergic effects with alpha effects predominating. The rare epinephrine-rich pheochromocytomas manifest a characteristic clinical syndrome in which the pharmacologic effects of epinephrine predominate over those of norepinephrine. Hypotensive crises and other characteristic manifestations of this entity appear to be related to predominance of stimulation of beta adrenergic over alpha adrenergic effects. The value of free catecholamine determinations in these patients is emphasized. Diagnostic and therapeutic use of alpha blocking agents apparently sensitizes the patient to beta adrenergic stimulation by epinephrine secretion. The use of adrenergic blocking agents in these patients is discussed. © 1969.