Inflammation-based Scores in Patients With Pheochromocytoma

Overview

Journal J Clin Endocrinol Metab

Publisher Oxford University Press

Specialty Endocrinology

Date 2024 Apr 24

PMID 38655872

Authors

Chiara Parazzoli

Alessandro Prete

Vittoria Favero

Carmen Aresta

Valentina Pucino

John Ayuk

Miriam Asia

Yasir S Elhassan

Iacopo Chiodini

Cristina L Ronchi

Affiliations

Soon will be listed here.

Abstract

Background: Pheochromocytoma is associated with systemic inflammation but the underlying mechanisms are unclear. Therefore, we investigated the relationship between plasma metanephrine levels and hematological parameters-as a surrogate of inflammation-in patients with pheochromocytoma and the influence of preoperative α-blockade treatment.

Design And Methods: We retrospectively studied 68 patients with pheochromocytoma who underwent adrenalectomy (median age, 53 years; 64.7% females) and 2 control groups matched for age, sex, and body mass index: 68 patients with nonfunctioning adrenocortical tumors and 53 with essential hypertension. The complete blood count and several inflammation-based scores (neutrophil-to-lymphocyte ratio [NLR], platelet-to-lymphocyte ratio [PLR], lymphocyte-to-monocyte ratio [LMR], systemic-immune-inflammation index [SII], prognostic-nutrition index) were assessed in all patients and, in a subset of pheochromocytomas, after adrenalectomy (n = 26) and before and after preoperative α-blockade treatment (n = 29).

Results: A higher inflammatory state, as indicated by both complete blood count and inflammation-based scores, was observed in patients with pheochromocytoma compared with nonfunctioning adrenocortical tumors and essential hypertension. Plasma metanephrine levels showed a positive correlation with NLR (r = 0.4631), PLR (r = 0.3174), and SII (r = 0.3709) and a negative correlation with LMR (r = 0.4368) and prognostic-nutrition index (r = 0.3741), even after adjustment for age, sex, ethnicity, body mass index, and tumor size (except for PLR). After adrenalectomy, we observed a reduction in NLR (P = .001), PLR (P = .003), and SII (P = .004) and a concomitant increase in LMR (P = .0002). Similarly, α-blockade treatment led to a reduction in NLR (P = .007) and SII (P = .03).

Conclusion: Inflammation-based scores in patients with pheochromocytoma showed pro-inflammatory changes that correlated with plasma metanephrine levels and are ameliorated by adrenalectomy and α-blockade.

Citing Articles

Associations of prognostic nutritional index with cardiovascular all-cause mortality among CVD patients with diabetes or prediabetes: evidence from the NHANES 2005-2018.

Xu W, Zhang L, Yang Q, Cao Y, Rao R, Lv L Front Immunol. 2025; 16:1518295.

PMID: 40013151 PMC: 11860081. DOI: 10.3389/fimmu.2025.1518295.

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