Cor Vasa 2006, 48(11):384-387 | DOI: 10.33678/cor.2006.124

Using free plasma metanephrines in the diagnosis of pheochromocytoma

Jan Václavík^1,*, David Stejskal^1,2, Bořek Lačňák¹, Václav Hanák¹, Marie Lazárová¹, Libor Jedelský², Lenka Kadalová², Marie Janošová², Zdeněk Fryšák³, Petr Vlček⁴

¹ Interní oddělení

² Oddělení laboratorní medicíny, Nemocnice Šternberk, Šternberk

³ III. interní klinika, Fakultní nemocnice Olomouc a Lékařská fakulta Univerzity Palackého, Olomouc

⁴ Klinika nukleární medicíny a endokrinologie, Fakultní nemocnice Motol a 2. lékařská fakulta Univerzity Karlovy, Praha, Česká republika

Introduction:
The critical step in diagnosing pheochromocytoma is biochemical evidence of hyperproduction of catecho-lamines or their metabolites.

Methods:
A cross-sectional multicenter study including 1,234 subjects assessed the diagnostic validity of determining plasma metanephrines in patients screened for resistant or markedly accelerated hypertension, paroxysmal hypertension, "flushes", adrenal incidentaloma or genetic predisposition to pheochromocytoma.

Results:
Pheochromocytoma was identified and verified by histology in 18 individuals (1.5%), with the diagnosis not
confirmed by long-term follow-up and use of imaging techniques in the remaining 1,216 individuals. Plasma metanephrine levels showed a sensitivity of 100%, specificity of 95%, and ROC AUC of 0.99. The respective values with plasma normetanephrine levels were 94.4%, 98.8%, and 0.99.

Conclusion:
Considering our and international experience, the satisfactory diagnostic validity of plasma metanephrines allows their utilization as a single screening test in cases of suspected pheochromocytoma.

Keywords: Pheochromocytoma; Metanephrine; Normetanephrine; Hypertension; Secondary hypertension

Published: November 1, 2006  Show citation