Exaggerated Urinary Norepinephrine Response to Tilt in Pheochromocytoma

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Abstract
A RECURRENT problem that we have encountered in the diagnosis of pheochromocytoma has appeared in patients with hypertensive attacks in whom periodic, but only modest, elevations of free catecholamine excretion occur. Our surgical service repeatedly has been referred patients with a diagnosis of pheochromocytoma already "established" on the basis of a convincing history of hypertensive attacks, slight elevations of free urinary catecholamine excretion and positive histamine and phentolamine (Regitine) tests. Frequently, these patients prove not to have a pheochromocytoma. In this circumstance we have found the determination of free urinary norepinephrine excretion before and after an ordinary tilt test to . . .