Approach to the Management of Gastrointestinal Manifestations in Patients With Phaeochromocytoma and Paraganglioma
Authors' conclusion
Optimal management of gastrointestinal symptoms in PPGL should consider disease characteristics such as primary location, secretory profile, alpha blockade and medication profile.
Study context
- Population
- Individuals with PPGL admitted for radionuclide therapy, chemotherapy, surgery or other medical illness, 2019–2024
- Participants
- 24 individuals
- Outcome
- GI symptom management in PPGL
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
- Metastatic disease
- 18 (75%)
- Antiemetic administration events for nausea or vomiting
- 50
- Acute colonic pseudo-obstruction
- 2 patients
- Received dopamine antagonists (metoclopramide)
- 10 patients
- Received corticosteroids (dexamethasone)
- 9 patients
- Majority of these alpha-blocked
- n = 7
- Majority of these with dopaminergic/biochemically silent phenotype
- n = 10
Observational data: associations, not effects.
Further findings
Literature review
- Evidence of dopamine antagonists and corticosteroids precipitating catecholaminergic crisis mostly limited to case reports
- Limited case reports: anti-cholinergic agents beneficial for acute colonic pseudo-obstruction
Safety
- Patients with biochemically negative/dopaminergic phenotypes or on alpha blockade with an antiemetic-related adverse event
- 0
- A patient with noradrenergic PPGL experienced a hypertensive episode following high-dose dexamethasone
Original publication
Approach to the Management of Gastrointestinal Manifestations in Patients With Phaeochromocytoma and Paraganglioma. Clin Endocrinol (Oxf). Published 24 March 2025. doi:10.
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