{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T08:07:01Z","timestamp":1790323621015,"version":"4.1.0"},"reference-count":7,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["IJU Case Reports"],"published-print":{"date-parts":[[2026,9]]},"abstract":"ABSTRACT<\/jats:title>\n \n Introduction<\/jats:title>\n Pheochromocytoma crisis complicated by catecholamine\u2010induced cardiomyopathy is a life\u2010threatening condition requiring careful preoperative management. Although metyrosine has recently been approved in Japan for the perioperative management of pheochromocytoma, clinical experience remains limited.<\/jats:p>\n <\/jats:sec>\n \n Case Presentation<\/jats:title>\n A 46\u2010year\u2010old man presented with pheochromocytoma crisis complicated by reverse Takotsubo cardiomyopathy and was diagnosed with bilateral pheochromocytomas. Given the preceding life\u2010threatening crisis, severe cardiac dysfunction, marked catecholamine excess, and bilateral disease, he was considered at high perioperative risk. Metyrosine was added to conventional \u03b1\u2010adrenergic blockade before one\u2010stage bilateral adrenalectomy. Metyrosine was well tolerated, and total urinary metanephrine decreased by approximately 76% without symptomatic hypotension. Although intraoperative blood pressure fluctuations still occurred, bilateral adrenalectomy was completed successfully.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n This case supports the feasibility of preoperative metyrosine administration in a high\u2010risk patient. Although its effect on intraoperative hemodynamic stability remains uncertain, metyrosine may be considered as an adjunct to conventional \u03b1\u2010adrenergic blockade in carefully selected patients.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/iju5.70267","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:21:16Z","timestamp":1789086076000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Preoperative Metyrosine Administration for Bilateral Pheochromocytomas Following Pheochromocytoma Crisis: A Case Report"],"prefix":"10.1002","volume":"9","author":[{"given":"Nanaho","family":"Demizu","sequence":"first","affiliation":[{"name":"Department of Urology and Renal Transplantation Yokohama City University Medical Center Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5173-6228","authenticated-orcid":false,"given":"Daiji","family":"Takamoto","sequence":"additional","affiliation":[{"name":"Department of Urology and Renal Transplantation Yokohama City University Medical Center Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tosihkazu","family":"Koike","sequence":"additional","affiliation":[{"name":"Department of Urology and Renal Transplantation Yokohama City University Medical Center Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeaki","family":"Noguchi","sequence":"additional","affiliation":[{"name":"Department of Urology and Renal Transplantation Yokohama City University Medical Center Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masanobu","family":"Yamazaki","sequence":"additional","affiliation":[{"name":"Department of Urology and Renal Transplantation Yokohama City University Medical Center Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1054-0779","authenticated-orcid":false,"given":"Akihito","family":"Hashizume","sequence":"additional","affiliation":[{"name":"Department of Urology and Renal Transplantation Yokohama City University Medical Center Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daiki","family":"Ueno","sequence":"additional","affiliation":[{"name":"Department of Urology and Renal Transplantation Yokohama City University Medical Center Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7049-3379","authenticated-orcid":false,"given":"Takashi","family":"Kawahara","sequence":"additional","affiliation":[{"name":"Department of Urology and Renal Transplantation Yokohama City University Medical Center Yokohama 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