Plasma catecholamines in pheochromocytoma: effect of urographic contrast media

Hypertensive crises have been provoked in pheochromocytoma patients by the injection of contrast media during angiography and venography. Fear of similar reactions to intravenous urographic contrast medium injection during computed tomography has led to studies without contrast enhancement when pheochromocytoma is suspected. With extraadrenal pheochromocytomas, intravenous contrast enhancement may be essential for tumor location by computed tomography. The catecholamine responses to injection of urographic contrast medium were examined in eight patients with pheochromocytoma and in 12 undergoing computed tomography for other reasons. Plasma norepinephrine concentrations fell in nonpheochromocytoma patients (p less than 0.005), while in pheochromocytoma patients the response was unpredictable, rising in six individuals, although the mean response was not significant (p greater than 0.35). In five patients the magnitude of the increase in norepinephrine concentrations was large enough to have led to a pressor effect had alpha adrenergic blockade not been used. It was concluded that intravenous urographic contrast medium may elevate plasma catecholamines in a significant proportion of patients with pheochromocytoma, but that with adequate alpha adrenergic blockade this should pose no threat.
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				P. S. Sethi, W. Hiser, H. Gaffar, L. Jiang, A. Islam, N. Bhatnagar, and M. Slawsky Fatal pheochromocytoma crisis precipitated by dobutamine stress echocardiography Eur J Echocardiogr, June 13, 2008; (2008) jen180v1. [Abstract] [Full Text] [PDF]

				R. Bessell-Browne and M. E. O'Malley CT of Pheochromocytoma and Paraganglioma: Risk of Adverse Events with IV Administration of Nonionic Contrast Material Am. J. Roentgenol., April 1, 2007; 188(4): 970 - 974. [Abstract] [Full Text] [PDF]

				M. A. Blake, M. K. Kalra, A. T. Sweeney, B. C. Lucey, M. M. Maher, D. V. Sahani, E. F. Halpern, P. R. Mueller, P. F. Hahn, and G. W. Boland Distinguishing Benign from Malignant Adrenal Masses: Multi-Detector Row CT Protocol with 10-Minute Delay Radiology, December 21, 2005; (2005) 2382041514. [Abstract] [Full Text]

				M. A. Blake, M. K. Kalra, M. M. Maher, D. V. Sahani, A. T. Sweeney, P. R. Mueller, P. F. Hahn, and G. W. Boland Pheochromocytoma: An Imaging Chameleon RadioGraphics, October 1, 2004; 24(suppl_1): S87 - S99. [Abstract] [Full Text] [PDF]

				I. Ilias and K. Pacak Current Approaches and Recommended Algorithm for the Diagnostic Localization of Pheochromocytoma J. Clin. Endocrinol. Metab., February 1, 2004; 89(2): 479 - 491. [Full Text] [PDF]

				M. A. Blake, S. K. Krishnamoorthy, G. W. Boland, A. T. Sweeney, M. B. Pitman, M. Harisinghani, P. R. Mueller, and P. F. Hahn Low-Density Pheochromocytoma on CT: A Mimicker of Adrenal Adenoma Am. J. Roentgenol., December 1, 2003; 181(6): 1663 - 1668. [Abstract] [Full Text] [PDF]

				T. H. Lee, C. M. Slywotzky, M. T. Lavelle, and R. A. Garcia Best Cases from the AFIP : Cystic Pheochromocytoma RadioGraphics, July 1, 2002; 22(4): 935 - 940. [Full Text] [PDF]