Clinical study
Diagnosis and localization of pheochromocytoma: Detection by measurement of urinary norepinephrine excretion during sleep, plasma norepinephrine concentration and computerized axial tomography (CT-scan)

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Abstract

The feasibility of differentiating patients with pheochromocytoma from other hypertensive patients by measuring urinary excretion rates of norepinephrine during sleep, a period of physiologic suppression of norepinephrine release, was investigated. The mean excretion rates of norepinephrine in 248 normal subjects and in 109 patients with essential hypertension were 1.03 ± 0.03 and 1.12 ± 0.06 (SEM) μ/hour, respectively, whereas the lowest excretion rate among the six patients with pheochromocytoma was about seven times higher. Plasma norepinephrine concentration in patients with pheochromocytoma was also consistently above the range observed in both normotensive and hypertensive subjects. CT scan correctly identified the same tumors visualized by selective arteriography. It is suggested that the usefulness of these approaches will provide simpler means of screening and detecting pheochromocytoma.

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    This study was supported, in part, by U.S.PHS Grants HL 14159, Specialized Center of Research (SCOR) in Hypertension and RR 00750 (General Clinical Research Center).

    1

    From the Departments of Medicine, Radiology und Urology, Indiana University School of Medicine, Lilly Laboratory for Clinical Research, Indianapolis, Indiana.

    Present address: Lilly Laboratory for Clinical Research, Wishard Memorial Hospital, 1001 West 10th Street, Indianapolis, Indiana 46202.

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