Metyrosine-associated endocrinological changes in pheochromocytoma and paraganglioma

Yuko Matsuo; Kenji Ashida; Ayako Nagayama; Kanoko Moritaka; Mizuki Gobaru; Junichi Yasuda; Naoyuki Ogasawara; Hirofumi Kurose; Katsuaki Chikui; Shimpei Iwata; Yukihiro Inoguchi; Nao Hasuzawa; Seiichi Motomura; Tsukasa Igawa; Masatoshi Nomura

doi:10.1530/EO-23-0006

Endocrine Oncology (Oct 2023)

Metyrosine-associated endocrinological changes in pheochromocytoma and paraganglioma

Yuko Matsuo,
Kenji Ashida,
Ayako Nagayama,
Kanoko Moritaka,
Mizuki Gobaru,
Junichi Yasuda,
Naoyuki Ogasawara,
Hirofumi Kurose,
Katsuaki Chikui,
Shimpei Iwata,
Yukihiro Inoguchi,
Nao Hasuzawa,
Seiichi Motomura,
Tsukasa Igawa,
Masatoshi Nomura

Affiliations

Yuko Matsuo: Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Asahi-machi, Kurume, Fukuoka, Japan
Kenji Ashida: Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Asahi-machi, Kurume, Fukuoka, Japan
Ayako Nagayama: Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Asahi-machi, Kurume, Fukuoka, Japan
Kanoko Moritaka: Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Asahi-machi, Kurume, Fukuoka, Japan
Mizuki Gobaru: Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Asahi-machi, Kurume, Fukuoka, Japan
Junichi Yasuda: Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Asahi-machi, Kurume, Fukuoka, Japan
Naoyuki Ogasawara: Department of Urology, Kurume University School of Medicine, Asahi-machi, Kurume, Fukuoka, Japan
Hirofumi Kurose: Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Asahi-machi, Kurume, Fukuoka, Japan
Katsuaki Chikui: Department of Urology, Kurume University School of Medicine, Asahi-machi, Kurume, Fukuoka, Japan
Shimpei Iwata: Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Asahi-machi, Kurume, Fukuoka, Japan
Yukihiro Inoguchi: Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Asahi-machi, Kurume, Fukuoka, Japan
Nao Hasuzawa: Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Asahi-machi, Kurume, Fukuoka, Japan
Seiichi Motomura: Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Asahi-machi, Kurume, Fukuoka, Japan
Tsukasa Igawa: Department of Urology, Kurume University School of Medicine, Asahi-machi, Kurume, Fukuoka, Japan
Masatoshi Nomura: Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Asahi-machi, Kurume, Fukuoka, Japan

DOI: https://doi.org/10.1530/EO-23-0006
Journal volume & issue: Vol. 3, no. 1
pp. 1 – 12

Abstract

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Objective: Metyrosine (alpha-methyl-para-tyrosine) effectively reduces catecholamine levels in patients with pheochromocytoma/paraganglioma. However, improvements in physiological and metabolic parameters and changes in endocrine function associated with metyrosine administration should be validated in comparison to surgery. This study was performed to confirm the effects of metyrosine on the physiol ogical, metabolic, and endocrinological functions of patients with pheochromocytoma/paraganglioma in the perioperative period. Design: This retrospective cohort study was performed at a single university hospital. Methods: We included ten patients with pheochromocytoma/paraganglioma who received oral metyrosine after α-blocker therapy and consecutive surgeries. Urinary catecholamine metabolite levels and other clinical parameters were evaluated before and after metyrosine administration, and 1 week after surgery. Results: The mean age was 53.1 ± 16.1 years. Of the ten participants (four men and six women), nine had pheochromocytoma and one had paraganglioma. The median maximum metyrosine dose was 750 mg/day. Urinary catecholamine metabolite levels significantly decreased in a dose-dependent manner after metyrosine administration. Both systolic and diastolic blood pressure significantly decreased after metyrosine and surgical treatment. Metyrosine administration significantly improved insulin sensitivity, although surgery improved the the basal insulin secretion. Additionally, serum prolactin and thyroid-stimulatory hormone levels were significantly increased by metyrosine treatment, whereas plasma renin activity was decreased. Conclusions: Metyrosine significantly reduced catecholamines in patients with pheochromocytoma/paraganglioma and ensured the safety of the surgery. Adjustment of metyrosine administration may make surgical pretreatment more effective in achieving stabilized blood pressure and improving glucose metabolism. Endocrine parameters may manifest as the systemic effects of metyrosine administration.

Published in Endocrine Oncology

ISSN: 2634-4793 (Online)
Publisher: Bioscientifica
Country of publisher: United Kingdom
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the endocrine glands. Clinical endocrinology; Medicine: Internal medicine: Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Website: https://eo.bioscientifica.com/

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