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August 1957

Chemical Determination of Urinary Catecholamines: An Aid in the Differential Diagnosis of Essential Hypertension and Pheochromocytoma

Author Affiliations

Los Angeles

From Bio-Science Laboratories.

AMA Arch Intern Med. 1957;100(2):196-200. doi:10.1001/archinte.1957.00260080022006

The classical description of patients with pheochromocytoma includes, as typical symptoms, paroxysmal hypertension, pallor, sweating, and tachycardia. It is now known that only a minority of patients exhibit such symptoms.1,2 The majority of cases manifest only a persistent hypertension and are difficult to differentiate from cases of essential hypertension. The proportion of pheochromocytomas among cases of hypertension, while small, is significant. Graham 3 encountered 8 cases, or 0.47%, of pheochromocytoma among 1700 unselected patients with hypertension subjected to bilateral lumbodorsal splanchnicectomy. If this percentage is correct, approximately 1 out of every 200 cases of hypertension involves a pheochromocytoma. It thus becomes important to have a highly specific method for the diagnosis of the latter disease.

The pharmacologic tests, such as the histamine, benzodioxane, and phentolamine (Regitine) tests, are known to yield both false-negative and false-positive tests.1,4,5 Since Engel and von Euler6 first pointed out in 1950 the

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