Horm Metab Res 2017; 49(10): 748-754
DOI: 10.1055/s-0043-117179
Endocrine Care
© Georg Thieme Verlag KG Stuttgart · New York

Excessive Catecholamine Secretion and the Activation of the Renin-Angiotensin-Aldosterone-System in Patients with Pheochromocytoma: A Single Center Experience and Overview of the Literature

Matthias Haase
1   Division for Specific Endocrinology, Medical Faculty, University of Duesseldorf, Duesseldorf, Germany
,
Till Dringenberg
1   Division for Specific Endocrinology, Medical Faculty, University of Duesseldorf, Duesseldorf, Germany
,
Stephanie Allelein
1   Division for Specific Endocrinology, Medical Faculty, University of Duesseldorf, Duesseldorf, Germany
,
Holger S. Willenberg
2   Division of Endocrinology and Metabolism, Rostock University Medical Center, Rostock, Germany
,
Matthias Schott
1   Division for Specific Endocrinology, Medical Faculty, University of Duesseldorf, Duesseldorf, Germany
› Author Affiliations
Further Information

Publication History

received 08 February 2017

accepted 13 July 2017

Publication Date:
24 August 2017 (online)

Abstract

Catecholamines stimulate renin-secretion in the juxtaglomerular cells of the kidney and a number of case reports suggest an association between pheochromocytoma and activation of the RAAS. Therefore, it could be asked whether patients suffering from pheochromocytoma with high concentrations of circulating catecholamines present with oversecretion of renin and aldosterone. We identified twelve patients with excessive catecholamine secretion due to pheochromocytoma and compared them to a group of twelve patients with essential hypertension (EH) with regard to the activation of the renin-angiotensin-aldosterone-system (RAAS). The PubMed database was screened for studies that investigate the association between pheochromocytoma and activation of the RAAS. The plasma concentrations of metanephrines (19.9-fold) and normetanephrines (29.5-fold) were significantly higher in the pheochromocytoma group than in the EH group. Renin and aldosterone levels were 1.3-fold and 1.6-fold higher, respectively, as compared to the EH group, whereas the differences were not statistically significant. There was no significant correlation between plasma metanephrine or normetanephrine levels and the plasma renin concentration (rs=0.077, rs=0.049, respectively) in our patients. The data from our institution and from review of literature suggest that an association between pheochromocytoma in the context of high plasma catecholamine levels and activation of the RAAS is present. However, results have not been consistent. Thus, other causes of RAAS-activation should be considered also in the presence of pheochromocytoma or reinvestigation for aldosteronism should be offered to such patients after removal of the catecholamine-producing tumour.

 
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