LANGLEY demonstrated in 1889 that nicotine exerts a stimulating effect on ganglion cells.1 Since that time many investigators have studied the response of chromaffin cells of the adrenal medulla, sympathetic ganglia, and sympathetic nerves to nicotine and smoking. However, a detailed report on the effects of smoking in a patient with a functioning paraganglioma has not previously appeared in the literature. This paper presents a patient with recurrent pheochromocytoma who experiences paroxysmal hypertensive attacks induced by smoking. It is felt that this case lends support to the postulate that the major physiologic effects of smoking are due to direct stimulation of chromaffin tissue and the subsequent release of catecholamines.
This report also represents an interesting sequel to a case previously presented in the literature by Hardy et al, in 1962.2
Report of a Case
A 27-year-old Negro housewife came to the Methodist Hospital Emergency Room on May 13,