Clonidine suppression testing for pheochromocytoma in neurofibromatosis type 1

BMJ Case Rep. 2019 Jun 25;12(6):e228263. doi: 10.1136/bcr-2018-228263.

Abstract

Compared with the general population, rates of pheochromocytoma are higher in neurofibromatosis type 1 (NF1) patients. However, pheochromocytoma testing is often plagued by false positive results. Here we present a patient with NF1, elevated urinary metanephrine levels, and an indeterminate adrenal nodule. Clonidine suppression testing aided diagnosis and led to definitive surgical treatment that confirmed a pheochromocytoma. Pheochromocytoma screening and clonidine suppression testing can both aid in the evaluation for catecholamine-secreting tumours.

Keywords: adrenal disorders; neuro genetics.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Gland Neoplasms / diagnosis*
  • Adrenal Gland Neoplasms / pathology
  • Adrenal Gland Neoplasms / surgery
  • Adrenergic alpha-2 Receptor Agonists / adverse effects
  • Adrenergic alpha-2 Receptor Agonists / pharmacology*
  • Clonidine / adverse effects
  • Clonidine / pharmacology*
  • False Positive Reactions
  • Female
  • Humans
  • Metanephrine / urine*
  • Middle Aged
  • Neurofibromatosis 1 / complications
  • Pheochromocytoma / diagnosis*
  • Pheochromocytoma / pathology
  • Pheochromocytoma / surgery

Substances

  • Adrenergic alpha-2 Receptor Agonists
  • Metanephrine
  • Clonidine