Pheochromocytoma

Pitfalls in the biochemical evaluation

Georgiana A. Dobri, Emmanuel Bravo, Amir Hamrahian

Research output: Contribution to journalReview article

Abstract

The current work-up of a patient suspected to have a pheochromocytoma starts with the measurement of plasma or urine metanephrines. Notably, up to a quarter of these patients will have a false positive result. When the plasma or urine metanephrines are less than the 4-fold upper limit of normal, clinicians struggle between the fear of missing a potentially fatal condition and ordering costly follow up tests. In many cases, ordering unnecessary imaging studies may only increase the level of patient anxiety. This article will review various physiologic factors, pathologic conditions and medications that may influence the levels of catecholamines and their metabolites yielding false positive or false negative results. Acquiring familiarity with these conditions as well as interfering medications will equip clinicians with better interpretation skills of the biochemical tests.

Original languageEnglish (US)
Pages (from-to)123-135
Number of pages13
JournalExpert Review of Endocrinology and Metabolism
Volume9
Issue number2
DOIs
StatePublished - Mar 1 2014
Externally publishedYes

Fingerprint

Pheochromocytoma
Metanephrine
Urine
Fear
Catecholamines
Anxiety

Keywords

  • Catecholamines
  • Dopamine
  • False negative
  • False positive
  • Metanephrines
  • Pheochromocytoma

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

Cite this

Pheochromocytoma : Pitfalls in the biochemical evaluation. / Dobri, Georgiana A.; Bravo, Emmanuel; Hamrahian, Amir.

In: Expert Review of Endocrinology and Metabolism, Vol. 9, No. 2, 01.03.2014, p. 123-135.

Research output: Contribution to journalReview article

Dobri, Georgiana A. ; Bravo, Emmanuel ; Hamrahian, Amir. / Pheochromocytoma : Pitfalls in the biochemical evaluation. In: Expert Review of Endocrinology and Metabolism. 2014 ; Vol. 9, No. 2. pp. 123-135.
@article{d33bcbdafc3e4f3d8d7a7bd58f2dd38d,
title = "Pheochromocytoma: Pitfalls in the biochemical evaluation",
abstract = "The current work-up of a patient suspected to have a pheochromocytoma starts with the measurement of plasma or urine metanephrines. Notably, up to a quarter of these patients will have a false positive result. When the plasma or urine metanephrines are less than the 4-fold upper limit of normal, clinicians struggle between the fear of missing a potentially fatal condition and ordering costly follow up tests. In many cases, ordering unnecessary imaging studies may only increase the level of patient anxiety. This article will review various physiologic factors, pathologic conditions and medications that may influence the levels of catecholamines and their metabolites yielding false positive or false negative results. Acquiring familiarity with these conditions as well as interfering medications will equip clinicians with better interpretation skills of the biochemical tests.",
keywords = "Catecholamines, Dopamine, False negative, False positive, Metanephrines, Pheochromocytoma",
author = "Dobri, {Georgiana A.} and Emmanuel Bravo and Amir Hamrahian",
year = "2014",
month = "3",
day = "1",
doi = "10.1586/17446651.2014.887985",
language = "English (US)",
volume = "9",
pages = "123--135",
journal = "Expert Review of Endocrinology and Metabolism",
issn = "1744-6651",
publisher = "Expert Reviews Ltd.",
number = "2",

}

TY - JOUR

T1 - Pheochromocytoma

T2 - Pitfalls in the biochemical evaluation

AU - Dobri, Georgiana A.

AU - Bravo, Emmanuel

AU - Hamrahian, Amir

PY - 2014/3/1

Y1 - 2014/3/1

N2 - The current work-up of a patient suspected to have a pheochromocytoma starts with the measurement of plasma or urine metanephrines. Notably, up to a quarter of these patients will have a false positive result. When the plasma or urine metanephrines are less than the 4-fold upper limit of normal, clinicians struggle between the fear of missing a potentially fatal condition and ordering costly follow up tests. In many cases, ordering unnecessary imaging studies may only increase the level of patient anxiety. This article will review various physiologic factors, pathologic conditions and medications that may influence the levels of catecholamines and their metabolites yielding false positive or false negative results. Acquiring familiarity with these conditions as well as interfering medications will equip clinicians with better interpretation skills of the biochemical tests.

AB - The current work-up of a patient suspected to have a pheochromocytoma starts with the measurement of plasma or urine metanephrines. Notably, up to a quarter of these patients will have a false positive result. When the plasma or urine metanephrines are less than the 4-fold upper limit of normal, clinicians struggle between the fear of missing a potentially fatal condition and ordering costly follow up tests. In many cases, ordering unnecessary imaging studies may only increase the level of patient anxiety. This article will review various physiologic factors, pathologic conditions and medications that may influence the levels of catecholamines and their metabolites yielding false positive or false negative results. Acquiring familiarity with these conditions as well as interfering medications will equip clinicians with better interpretation skills of the biochemical tests.

KW - Catecholamines

KW - Dopamine

KW - False negative

KW - False positive

KW - Metanephrines

KW - Pheochromocytoma

UR - http://www.scopus.com/inward/record.url?scp=84896719005&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84896719005&partnerID=8YFLogxK

U2 - 10.1586/17446651.2014.887985

DO - 10.1586/17446651.2014.887985

M3 - Review article

VL - 9

SP - 123

EP - 135

JO - Expert Review of Endocrinology and Metabolism

JF - Expert Review of Endocrinology and Metabolism

SN - 1744-6651

IS - 2

ER -