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Improved Safety of Glucagon Testing for Pheochromocytoma by Prior -Receptor Blockade

A Controlled Trial in a Patient With a Mixed Ganglioneuroma/Pheochromocytoma

William J. Elliott, MD, PhD; Michael B. Murphy, MD; Francis H. Straus II, MD; Joseph Jarabak, MD, PhD

Arch Intern Med. 1989;149(1):214-216.

Abstract
• The glucagon stimulation test has been superseded in recent years by the clonidine suppression test because it can provoke dangerous increases in blood pressure in patients with pheochromocytomas. We describe the first patient in whom a pheochromocytoma was diagnosed by a glucagon test, after which the blood pressure (but not the plasma catecholamine) response to a second injection of glucagon was blocked by pretreatment with phenoxybenzamine. After the tumor (which contained both pheochromocytoma and ganglioneuroma tissue) was removed, a third glucagon test result was negative. This experience suggests that patients with normal plasma catecholamine levels who are suspected of harboring a pheochromocytoma may be accurately diagnosed, but potentially dangerous increases in blood pressure may be minimized, by performing the glucagon test after -adrenergic blockade.

(Arch Intern Med 1989;149:214-216)

Author Affiliations
From the Departments of Medicine (Drs Elliott, Murphy, and Jarabak) and Pathology (Dr Straus), The University of Chicago.

Footnotes
Accepted for publication May 31, 1988.

Reprint requests to the Committee on Clinical Pharmacology, The University of Chicago, Box 271, 947 E 58th St, Chicago, IL 60637 (Dr Elliott).

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