Brief communication: radiographic contrast infusion and catecholamine release in patients with pheochromocytoma.
BACKGROUND
Contrast-enhanced computed tomography (CT) is useful for localizing pheochromocytoma. However, in patients with suspected pheochromocytoma, CT is often canceled or not performed because of the strong belief that intravenous contrast may induce hypertensive crisis.


OBJECTIVE
To examine whether intravenous low-osmolar contrast administration during CT induces catecholamine release that increases blood pressure or heart rate.


METHODS
Prospective study.


METHODS
Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland.


METHODS
22 patients with pheochromocytoma (15 nonadrenal and 7 adrenal) and 8 unmatched control participants without pheochromocytoma.


METHODS
Plasma catecholamine levels, blood pressure, and heart rate.


RESULTS
Plasma catecholamine levels within and between groups did not significantly differ before and after intravenous administration of low-osmolar CT contrast. Patients with pheochromocytoma experienced a clinically and statistically significant increase in diastolic blood pressure that was not accompanied by corresponding increases in plasma catecholamine levels. The difference became non-statistically significant after adjustment for use of alpha- and beta-blockers.


CONCLUSIONS
The study lacked a placebo group, and the sample was relatively small.


CONCLUSIONS
Intravenous low-osmolar contrast-enhanced CT can safely be used in patients with pheochromocytoma who are not receiving alpha- or beta-blockers.


BACKGROUND
Eunice Kennedy Shriver National Institute of Child Health and Development, National Institutes of Health.
Baid
Smita K
SK
Eunice Kennedy Shriver National Institute of Child Health and Human Development and Warren G Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland 20892-1109, USA.
Lai
Edwin W
EW
Wesley
Robert A
RA
Ling
Alex
A
Timmers
Henri J L M
HJ
Adams
Karen T
KT
Kozupa
Anna
A
Pacak
Karel
K
D000310:Adrenal Gland Neoplasms / Q000097:blood / Q000000981:diagnostic imaging; D000328:Adult; D001794:Blood Pressure / Q000187:drug effects; D002395:Catecholamines / Q000097:blood*; D003287:Contrast Media / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000139:chemically induced*; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D009994:Osmolar Concentration; D010673:Pheochromocytoma / Q000097:blood* / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed / Q000009:adverse effects* / Q000379:methods; D055815:Young Adult
D002395:Catecholamines; D003287:Contrast Media