Excretion of adrenaline, noradrenaline, vanilmandelic acid and metanephrines in 64 patients with pheochromocytoma. Results of repeated analyses in patients with sustained and paroxysmal hypertension.

Sixty-four patients with pheochromocytoma were operated upon at Sahlgrenska Hospital during 1956-82. The excretion of adrenaline and/or noradrenaline as well as their metabolites was high at each observation in 28 subjects with sustained hypertension, one patient, however, showing only slightly increased excretion of adrenaline at one observation. Another of the hypertensive patients consistently displayed normal amounts of vanilmandelic acid and metanephrines. Most of 28 patients with paroxysmal hypertension showed similar results. In five subjects with few attacks, however, normal findings were obtained on one or several occasions. Among the remaining patients the excretion of catecholamines was normal in the face of severe hypertension in two, the high blood pressure being probably due to diseases other than pheochromocytoma. Five normotensive subjects without hypertensive attacks presented variable findings. The results from analyses of catecholamines were somewhat more helpful than those from measurements of vanilmandelic acid, which failed completely in one hypertensive patient and in three others with paroxysmal attacks.