Ces patients ont été répartis en deux groupes en fonction des concentrations plasmatiques prédominantes de norépinéphrine ou d'épinéphrine. We conclude that the plasma catecholamine type and its level are the most important factors in determining the patterns of blood pressure disturbances of patients with pheochromocytoma.Ĭinquante six patients ayant un phéochromocytome ont été opérés en 9 ans (1981–1990). Tumor size showed no correlation with the plasma levels of catecholamine in the moderate to high plasma catecholamine groups. In norepinephrine-secreting patients, urinary dopamine tended to be inversely correlated with the plasma norepinephrine level however dopamine did not prevent the hypertensive action of norepinephrine. In the norepinephrine dominant group, urinary dopamine excretion tended to be proportional to the plasma epinephrine levels and when the patients were normotensive, urinary dopamine excretion decreased.

Urinary excretion of dopamine and size of the tumor were analyzed according to these patient groups. In the majority of normotensive patients (12 of 14), plasma catecholamine levels were <10 times the upper normal limit.

Thirteen patients with high plasma norepinephrine levels (≥10 times normal) had sustained hypertension while 18 patients with moderate to high plasma epinephrine levels (≥5 times normal) had paroxysmal hypertension.

Pre-operative disturbances of blood pressure, sustained or paroxysmal, and normal blood pressure were highly correlated with the dominantly secreted catecholamine and its plasma concentration. Plasma levels of the catecholamines were stratified into three grades at 5 and 10 times the normal upper limit. These patients were divided into two groups according to whether the dominant plasma concentration was of epinephrine or norepinephrine. Fifty-six patients with pheochromocytoma underwent surgery during the 9-year period from 1981 to 1990.

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