Plasma metanephrines: a novel and cost-effective test for pheochromocytoma

Brazilian Journal of Medical and Biological Research

G. Eisenhofer²  M. Walther¹  H.r. Keiser¹  J.w.m. Lenders¹  P. Friberg¹  K. Pacak² 

[1] ,National Institutes of Health National Institute of Neurological Disorders and Stroke Clinical Neurocardiology Section

关键词: pheochromocytoma;    hypertension;    sympathetic nervous system;    adrenal gland;    metanephrines;    catecholamines;   

DOI  :  10.1590/S0100-879X2000001000005

来源: SciELO

【 摘 要 】

Pheochromocytomas are rare chromaffin cell tumors that nevertheless must be excluded in large numbers of patients who develop sustained or episodic hypertension as well as in many others with suggestive symptoms or with a familial history of pheochromocytoma. Diagnosis of pheochromocytoma depends importantly on biochemical evidence of excess catecholamine production by a tumor. Imperfect sensitivity and specificity of commonly available biochemical tests and the low incidence of the tumor among the tested population mean that considerable time and effort can be expended in confirming or ruling out pheochromocytoma in patients where the tumor is suspected. Measurements of plasma free metanephrines provide a superior test compared to other available tests for diagnosis of pheochromocytoma. In particular, the high sensitivity of plasma free metanephrines means that a normal test result reliably excludes all but the smallest of pheochromocytomas so that no other tests are necessary. Measurements of plasma free metanephrines, when systematically combined with other diagnostic procedures outlined in this review, provide a more efficient, reliable and cost-effective approach for diagnosis of pheochromocytoma than offered by previously available approaches.

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