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Failure of Classical β-Blocker Carvedilol to Deactivate Brown Adipose Tissue in a Patient With Pheochromocytoma

Tsechelidis, Ioannis, MD; El Darazi, Eva, MD; Muteganya, Raoul, MD; Weyts, Kathleen, MD; Goldman, Serge, MD

doi: 10.1097/RLU.0000000000002170
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A 37-year-old woman with pheochromocytoma underwent presurgical FDG PET/CT. Despite her usual antiadrenergic medication consisting in 25 mg of carvedilol, PET/CT demonstrated intense and widespread FDG uptake in brown adipose tissue (BAT). No BAT FDG uptake was detectable on a repeated examination after specific preparation consisting in 40 mg propranolol and 5 mg diazepam. We therefore recommend this propranolol-diazepam preparation in patients with pheochromocytoma referred for PET/CT. Carvedilol—classically prescribed to alleviate effects of adrenergic overstimulation—seems ineffective on BAT. This observation questions the benefit of carvedilol to reduce β3-adrenoreceptor–mediated effects, not only in BAT, but also in other tissues.

From the Service de Médecine Nucléaire, Hôpital Erasme, Université libre de Bruxelles, Brussels, Belgium.

Received for publication March 19, 2018; revision accepted May 6, 2018.

Conflicts of interest and sources of funding: The Department of Nuclear Medicine at Erasme Hospital is supported by the Association Vinçotte Nuclear, the Fonds Erasme, and the Walloon Region (Biowin). None declared to all authors.

Correspondence to: Serge Goldman, MD, Service de Médecine Nucléaire, Hôpital Erasme, 808 Route de Lennik, B-1070 Brussels, Belgium. E-mail:

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