Cited by 503Adrenal and Paraganglionic TumorsNeuroendocrine Tumor Research AdvancesMetabolism and Genetic Disorders

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A Comparison of Biochemical Tests for Pheochromocytoma: Measurement of Fractionated Plasma Metanephrines Compared with the Combination of 24-Hour Urinary Metanephrines and Catecholamines

Sawka, Anna M., Jaeschke, Roman, Singh, Ravinder J., Young, William F.·2003·The Journal of Clinical Endocrinology & Metabolism

DOI 10.1210/jc.2002-021251

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Abstract

We compared the diagnostic efficacy of fractionated plasma metanephrine measurements to measurements of 24-h urinary total metanephrines and catecholamines in outpatients tested for pheochromocytoma at Mayo Clinic Rochester from January 1, 1999, until November 27, 2000. Catecholaminesecreting tumors were histologically proven. The sensitivity of fractionated plasma metanephrines was 97% (30 of 31 patients), compared with a sensitivity of 90% (28 of 31) for urinary total metanephrines and catecholamines (P = 0.63). The specificity of fractionated plasma metanephrines was 85% (221 of 261), compared with 98% (257 of 261; P < 0.001) for urinary measurements. The likelihood ratios for positive tests were 6.3 (95% confidence interval, 4.7 to 8.5) for fractionated plasma metanephrines and 58.9 (95% confidence interval, 22.1 to 156.9) for urinary total metanephrines and catecholamines. An adrenal pheochromocytoma was missed by urinary testing in two patients with familial syndromes and one asymptomatic patient with an incidentally discovered adrenal mass. An extra-adrenal paraganglioma was missed by plasma testing in one patient. In conclusion, measurements of 24-h urinary total metanephrines and catecholamines yield fewer false-positive results, an attribute preferred for testing low-risk patients, but fractionated plasma metanephrine measurements may be preferred in high-risk patients with familial endocrine syndromes.

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Authors: Sawka, A. M., Jaeschke, R., Singh, R. J., & Young, W. F.
Affiliations: Mayo Clinic (US)
St. Joseph’s Healthcare Hamilton (CA)
ORCID: Sawka, Anna M.
Singh, Ravinder J.
Young, William F.
Venue: The Journal of Clinical Endocrinology & Metabolism
Publisher: The Endocrine Society
Published: 2003-02
Volume: 88
Issue: 2
Pages: 553-558
ISSN: 0021-972X (ISSN-L)
1945-7197
DOI: 10.1210/jc.2002-021251
OpenAlex: W1979170245
Cited by: 503
References: 24
Citations by year: 2026: 8 · 2025: 12 · 2024: 10 · 2023: 8 · 2022: 21 · 2021: 18 · 2020: 14 · 2019: 17 · 2018: 10 · 2017: 24 · 2016: 21 · 2015: 19 · 2014: 29 · 2013: 27 · 2012: 22
FWCI: 25.89
Type: journal article
Language: en
Open access: closed
Locations: The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
PubMed (publishedVersion)
Funders: Mayo Clinic
Topics: Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
Health Sciences › Medicine › Oncology › Neuroendocrine Tumor Research Advances
Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Metabolism and Genetic Disorders
Keywords: pheochromocytoma, catecholamines, sensitivity and specificity, likelihood ratios, paraganglioma, adrenal incidentaloma, false positives
MeSH terms: Adolescent, Adrenal Gland Neoplasms, Adult, Aged, Aged, 80 and over, Catecholamines, Child, Female, Head and Neck Neoplasms, Humans, Male, Metanephrine, Middle Aged, Outpatients, Paraganglioma, Pheochromocytoma, Sensitivity and Specificity

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A Comparison of Biochemical Tests for Pheochromocytoma: Measurement of Fractionated Plasma Metanephrines Compared with the Combination of 24-Hour Urinary Metanephrines and Catecholamines

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