Henry Ford Hospital Medical Journal


Pheochromocytoma is a major cause of morbidity in multiple endocrine neoplasia type 2. We recommend a similar diagnostic screening approach for early asymptomatic pheochromocytoma as is generally accepted for asymptomatic medullary thyroid carcinoma. We present a new provocative test for early asymptomatic pheochromocytoma. Plasma epinephrine levels and epinephrine/dopamine ratios after physical exercise seem to have higher sensitivity than basal plasma catecholamine levels. Specificity is high especially for discrimination from neurovegetative lability, which is the clinically most important differential diagnosis.