Horm Metab Res 2011; 43(4): 292-295
DOI: 10.1055/s-0030-1270520
Humans, Clinical

© Georg Thieme Verlag KG Stuttgart · New York

The Effect of Exogenous Glucocorticoids on Plasma Catecholamines and Metanephrines in Patients Without Phaeochromocytomas

M. R. Druce1 , D. Walker1 , K. T. Maher1 , K. Dodzo1 , L. Perry2 , S. Ball3 , R. Peaston4 , S. L. Chew1 , W. M. Drake1 , S. A. Akker1 , A. B. Grossman1
  • 1Department of Endocrinology, Barts and the London Medical School, St Bartholomew's Hospital, London, UK
  • 2Department of Chemical Pathology, Barts and the London Medical School, St Bartholomew's Hospital, London, UK
  • 3Department of Endocrinology, Barts and the London Medical School, St Bartholomew's Hospital, London, UK
  • 4Department of Chemical Pathology, Newcastle University Hospital, Newcastle, UK
Further Information

Publication History

received 25.09.2010

accepted 23.12.2010

Publication Date:
24 January 2011 (online)

Abstract

The aim of the study was to evaluate the effects of steroid administration under standardised conditions in a range of patients both normal and with adrenal pathologies and to review the impact on plasma catecholamines and metanephrines. Corticosteroid administration has been linked to the development of hypertensive crises in patients with phaeochromocytoma, however a mechanism for this is not fully understood. We aimed to add useful information about the effect of steroids on levels of these hormones under usual circumstances. A prospective, observational cohort study of 50 patients undergoing the low-dose dexamethasone suppression test (LDDST) was undertaken. Additional blood samples were taken at the start and end of the standard LDDST. Biochemical analysis was carried out for plasma catecholamines and plasma free metanephrines. Demographic and hormonal data were acquired from review of the notes or measured at baseline. No significant changes in plasma catecholamines or metanephrines were seen at the end of the LDDST compared to baseline. This was also true of subgroup analysis, divided by age, gender, or type of underlying pathology. Our results suggest that hypertensive reaction responses, rare as they are, are unlikely to be related to normal adrenal physiology. Thus LDDST is likely to be safe under most circumstances, however caution should be exercised in patients with adrenal masses with imaging characteristics compatible with phaeochromocytoma. It may be prudent to defer glucocorticoid administration until functioning phaeochromocytoma has been excluded biochemically.

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Correspondence

Dr. M. R. Druce

Department of Endocrinology

St Bartholomew's Hospital

London EC1A 7BE

United Kingdom

Phone: +44/203 465 5378

Fax: +44/203 465 6148

Email: m.r.druce@qmul.ac.uk

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