Biochemical detection of phaeochromocytoma: why are we continuing to ignore the evidence?

Abstract Phaeochromocytomas are rare tumours that require consideration among large numbers of patients with hypertension. If not diagnosed, the excessive secretion of catecholamines by these tumours can cause considerable morbidity and mortality. With a wide clinical variability in presentation, di...

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Bibliographic Details
Published in:Annals of clinical biochemistry 2008-01, Vol.45 (1), p.6-10
Main Authors: Peaston, Robert T, Ball, Stephen
Format: Article
Language:English
Subjects:
Biomarkers, Tumor - blood
Biomarkers, Tumor - urine
Humans
Mass Screening
Metanephrine - blood
Metanephrine - urine
Pheochromocytoma - blood
Pheochromocytoma - diagnosis
Pheochromocytoma - urine
Sensitivity and Specificity
United Kingdom
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Summary:Abstract Phaeochromocytomas are rare tumours that require consideration among large numbers of patients with hypertension. If not diagnosed, the excessive secretion of catecholamines by these tumours can cause considerable morbidity and mortality. With a wide clinical variability in presentation, diagnosis can be difficult and invariably requires the biochemical confirmation of excessive catecholamine production by the tumour. At the First International Symposium on Phaeochromocytoma in October 2005, a panel of experts recommended that initial biochemical testing for phaeochromocytoma should include measurements of plasma and urinary metadrenalines. The accumulated evidence clearly indicates that measurement of fractionated metadrenalines in urine or plasma provides superior diagnostic sensitivity over plasma or urine measurements of catecholamines and metabolites. The low prevalence of phaeochromocytoma and paraganglioma (PGL) emphasizes the need to use biochemical tests of the highest sensitivity. To achieve this, it is recommended that the initial biochemical testing for phaeochromocytoma and secreting PGL should always include the measurements of metadrenalines in plasma or urine or both.
ISSN:0004-5632
1758-1001
DOI:10.1258/acb.2007.007116