0 NE and E (in Pheochromocytomas)

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About 50% of adrenal pheochromocytomas produce near exclusively norepinephrine, this representing the same pattern as in extra-adrenal pheochromocytomas.

Production of epinephrine (best detected by an increase in metanephrine) indicates an adrenal location,

exclusive production of norepinephrine (best indicated by increases of normetanephrine with normal metanephrine) may reflect either an adrenal or extra-adrenal location.

Practically all epinephrine-producing pheochromocytomas are found in the adrenal gland or are recurrences of previously resected adrenal tumors.

All of the catecholamines are broken down into inactive substances that appear in the urine:
  • Dopamine becomes Homovanillic acid (HVA)
  • Norepinephrine becomes normetanephrine and vanillylmandelic acid (VMA)
  • Epinephrine becomes metanephrine and VMA

EffectEpinephrineNorepinephrine
Heart rateincreasesdecreases
Cardiac outputincreasesvariable
Blood pressureincreasesincreases
Respirationincreasesincreases
Metabolismincreasessmall increase
Behaviorpassive, tenseaggressive
Eosinophil countincreases----
Skin blood vesselsdilateconstrict
Muscle blood vesselsdilatesmall dilation

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