Free plasma metanephrines as a screening test for pheochromocytoma in low-risk patients.

Abstract

OBJECTIVES:

Detection of free plasma metanephrines seems to be the most exact method for biochemical diagnosis of pheochromocytoma, but their diagnostic efficacy in the common low-risk clinical settings is debated.

METHODS:

A cross-sectional multicentre study including 1260 subjects assessed the diagnostic efficacy of free plasma metanephrine and normetanephrine in low-risk patients screened for resistant or markedly accelerated hypertension, paroxysmal hypertension, 'flushes' and, in a small proportion, for adrenal incidentaloma or genetic predisposition to pheochromocytoma.

RESULTS:

Pheochromocytoma was identified and verified by histology in 25 subjects (2%), with the diagnosis not confirmed by long-term follow-up or use of imaging techniques in the remaining 1235 individuals. The combined assay of free plasma metanephrines was a highly sensitive (100%) and specific (96.7%) measure, yielding a negative predictive value of 100%.

CONCLUSION:

The satisfactory diagnostic efficacy of free plasma metanephrines allows their use as a single screening test in cases of suspected pheochromocytoma in the population with a low pretest probability.

• Authors: Jan Václavík, David Stejskal, Borek Lacnák, Marie Lazárová, Libor Jedelský, Lenka Kadalová, Marie Janosová, Zdenek Frysák, Petr Vlcek
• Journal: Journal of hypertension (J Hypertens) Vol. 25 Issue 7 Pg. 1427-31 (Jul 2007) ISSN: 0263-6352 [Print] England
• PMID: 17563565 (Publication Type: Journal Article, Multicenter Study)

Chemical References

• Normetanephrine
• Metanephrine

Topics

• Adrenal Gland Neoplasms (blood, diagnosis, epidemiology)
• Area Under Curve
• Cross-Sectional Studies
• Czech Republic (epidemiology)
• Female
• Humans
• Male
• Mass Screening (methods)
• Metanephrine (blood)
• Middle Aged
• Normetanephrine (blood)
• Pheochromocytoma (blood, diagnosis, epidemiology)
• Predictive Value of Tests