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Clinical Chemistry, Vol 37, 1854-1867, Copyright © 1991 by American Association for Clinical Chemistry
TG Rosano, TA Swift and LW Hayes
Department of Pathology and Laboratory Medicine, Albany Medical Center, NY 12208.
Assessment of catecholamine production and excretion is important in the laboratory detection of pheochromocytoma, a rare but curable cause of hypertension. Advances in catecholamine and metabolite methodologies have enhanced the diagnostic acumen by increasing analytical sensitivity and eliminating many of the interferences observed with earlier methods. Estimation of urinary catecholamines metanephrine and vanillylmandelic acid is routinely used in the biochemical detection of pheochromocytoma and in monitoring the completeness of tumor excision as well as the possibility of recurrence. Traditional spectrophotometric and fluorometric methods for urinary catecholamines and their metabolites are being replaced by highly sensitive and selective chromatographic methods. The ability to quantify individual catecholamines and metanephrines by high-performance liquid chromatography is of particular value for detecting familial forms of the tumor that may secrete epinephrine. Plasma norepinephrine and epinephrine measurements are of additional diagnostic value in determining recent catecholamine release and response to clonidine suppression. For either urine or plasma measurements, appropriate patient preparation, sample collection, and method validation along with an understanding of the variable pattern of catecholamine secretion and metabolism in pheochromocytoma are essential. Advances in laboratory methodology and reference intervals for catecholamines for clinical interpretation are reviewed.
The following articles in journals at HighWire Press have cited this article:
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  A. Karagiannis, D. P Mikhailidis, V. G Athyros, and F. Harsoulis Pheochromocytoma: an update on genetics and management Endocr. Relat. Cancer, December 1, 2007; 14(4): 935 - 956. [Abstract] [Full Text] [PDF]
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 J. G. Boyle, D. F. Davidson, C. G. Perry, and J. M. C. Connell Comparison of Diagnostic Accuracy of Urinary Free Metanephrines, Vanillyl Mandelic Acid, and Catecholamines and Plasma Catecholamines for Diagnosis of Pheochromocytoma J. Clin. Endocrinol. Metab., December 1, 2007; 92(12): 4602 - 4608. [Abstract] [Full Text] [PDF]
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 T. LENZ, J. ZORNER, C. KIRCHMAIER, D. PILLITTERI, K. BADENHOOP, C. BARTEL, H. GEIGER, K. HASSELBACHER, U. TUSCHY, J. WESTERMANN, et al. Multicenter Study on the Diagnostic Value of a New RIA for the Detection of Free Plasma Metanephrines in the Work-Up for Pheochromocytoma. Ann. N.Y. Acad. Sci., August 1, 2006; 1073: 358 - 373. [Abstract] [Full Text] [PDF]
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 J. Sullivan, T. Groshong, and J. D. Tobias Presenting Signs and Symptoms of Pheochromocytoma in Pediatric-aged Patients Clinical Pediatrics, October 1, 2005; 44(8): 715 - 719. [Abstract] [PDF]
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G. Eisenhofer Biochemical Diagnosis of Pheochromocytoma--Is it Time to Switch to Plasma-Free Metanephrines? J. Clin. Endocrinol. Metab., February 1, 2003; 88(2): 550 - 552. [Full Text] [PDF]
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M. Weise, D. P. Merke, K. Pacak, M. M. Walther, and G. Eisenhofer Utility of Plasma Free Metanephrines for Detecting Childhood Pheochromocytoma J. Clin. Endocrinol. Metab., May 1, 2002; 87(5): 1955 - 1960. [Abstract] [Full Text] [PDF]
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 M. Roden, W. Raffesberg, W. Raber, E. Bernroider, B. Niederle, W. Waldhausl, and S. Gasic Quantification of Unconjugated Metanephrines in Human Plasma without Interference by Acetaminophen Clin. Chem., June 1, 2001; 47(6): 1061 - 1067. [Abstract] [Full Text] [PDF]
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 L. B. WARE and M. A. MATTHAY Alveolar Fluid Clearance Is Impaired in the Majority of Patients with Acute Lung Injury and the Acute Respiratory Distress Syndrome Am. J. Respir. Crit. Care Med., May 1, 2001; 163(6): 1376 - 1383. [Abstract] [Full Text]
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J. Wassell, P. Reed, J. Kane, and C. Weinkove Freedom from Drug Interference in New Immunoassays for Urinary Catecholamines and Metanephrines Clin. Chem., December 1, 1999; 45(12): 2216 - 2223. [Abstract] [Full Text] [PDF]
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 G. M. Verghese, L. B. Ware, B. A. Matthay, and M. A. Matthay Alveolar epithelial fluid transport and the resolution of clinically severe hydrostatic pulmonary edema J Appl Physiol, October 1, 1999; 87(4): 1301 - 1312. [Abstract] [Full Text] [PDF]
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T. J. Panholzer, J. Beyer, and K. Lichtwald Coupled-Column Liquid Chromatographic Analysis of Catecholamines, Serotonin, and Metabolites in Human Urine Clin. Chem., February 1, 1999; 45(2): 262 - 268. [Abstract] [Full Text] [PDF]
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R. Z. Shi, Y.-P. Ho, J. H. K. Yeung, P. M. Y. Or, K. K. W. To, M. W. M. Lau, and M. Arumanayagam Development of an enzyme-linked immunosorbent assay with monoclonal antibody for quantification of homovanillic in human urine samples Clin. Chem., August 1, 1998; 44(8): 1674 - 1679. [Abstract] [Full Text] [PDF]
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G. A. Smythe, M. W. Duncan, J. Grassi, and P. Pradelles Immunoassay of Catecholamines and Metabolites • Two of the authors of the article referred to reply: Clin. Chem., October 1, 1997; 43(10): 2011 - 2012. [Full Text]
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F. Taran, Y. Frobert, C. Creminon, J. Grassi, D. Olichon, C. Mioskowski, and P. Pradelles Competitive enzyme immunoassay with monoclonal antibody for homovanillic acid measurement in human urine samples Clin. Chem., February 1, 1997; 43(2): 363 - 368. [Abstract] [Full Text] [PDF]
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B. G. Wolthers, I. P. Kema, M. Volmer, R. Wesemann, J. Westermann, and B. Manz Evaluation of urinary metanephrine and normetanephrine enzyme immunoassay (ELISA) kits by comparison with isotope dilution mass spectrometry Clin. Chem., January 1, 1997; 43(1): 114 - 120. [Abstract] [Full Text] [PDF]
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