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November 23, 1984

Snuff-Induced Hypertension in Pheochromocytoma

Author Affiliations

From the Department of Internal Medicine, University of Texas Health Science Center at Dallas, Southwestern Medical School.

JAMA. 1984;252(20):2860-2862. doi:10.1001/jama.1984.03350200046020

The dipping of snuff provoked paroxysmal hypertension that induced myocardial ischemia in a 69-year-old woman with pheochromocytoma. The diagnosis of her tumor was delayed by a report of a falsely low urine metanephrine level, resulting from interference with the metanephrine assay by meglumine present in the urine because of contrast coronary angiography performed on the day of urine collection.

(JAMA 1984;252:2860-2862)

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