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Measurements of Plasma Methoxytyramine, Normetanephrine, and Metanephrine as Discriminators of Different Hereditary Forms of Pheochromocytoma
Open accessAbstract
BACKGROUND: Pheochromocytomas are rare catecholamine-producing tumors derived in more than 30% of cases from mutations in 9 tumor-susceptibility genes identified to date, including von Hippel-Lindau tumor suppressor (VHL); succinate dehydrogenase complex, subunit B, iron sulfur (Ip) (SDHB); and succinate dehydrogenase complex, subunit D, integral membrane protein (SDHD). Testing of multiple genes is often undertaken at considerable expense before a mutation is detected. This study assessed whether measurements of plasma metanephrine, normetanephrine, and methoxytyramine, the O-methylated metabolites of catecholamines, might help to distinguish different hereditary forms of the tumor. METHODS: Plasma concentrations of O-methylated metabolites were measured by liquid chromatography with electrochemical detection in 173 patients with pheochromocytoma, including 38 with multiple endocrine neoplasia type 2 (MEN 2), 10 with neurofibromatosis type 1 (NF1), 66 with von Hippel-Lindau (VHL) syndrome, and 59 with mutations of SDHB or SDHD. RESULTS: In contrast to patients with VHL, SDHB, and SDHD mutations, all patients with MEN 2 and NF1 presented with tumors characterized by increased plasma concentrations of metanephrine (indicating epinephrine production). VHL patients usually showed solitary increases in normetanephrine (indicating norepinephrine production), whereas additional or solitary increases in methoxytyramine (indicating dopamine production) characterized 70% of patients with SDHB and SDHD mutations. Patients with NF1 and MEN 2 could be discriminated from those with VHL, SDHB, and SDHD gene mutations in 99% of cases by the combination of normetanephrine and metanephrine. Measurements of plasma methoxytyramine discriminated patients with SDHB and SDHD mutations from those with VHL mutations in an additional 78% of cases. CONCLUSIONS: The distinct patterns of plasma catecholamine O-methylated metabolites in patients with hereditary pheochromocytoma provide an easily used tool to guide cost-effective genotyping of underlying disease-causing mutations.
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“Additionally, measurements of plasma methoxytyramine discriminated patients with SDH mutations from those with VHL mutations in a further 78% of cases (181).”
From Adrenal incidentaloma (2020) · cites this paper as [181]
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“In 1 large study of patients with pheochromocytoma and/or paraganglioma, patients with NF1 and MEN2 mutations could be discriminated from those with VHL and SDH mutations in 99% of cases by the relative concentrations of normetanephrine and metanephrine, as all patients with NF1 and MEN2 presented with tumors characterized by increased plasma concentrations of metanephrine, in contrast to patients”
From Adrenal incidentaloma (2020) · cites this paper as [181]
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Lenders, J. W. M., Eisenhofer, G., Mannelli, M., & Pacák, K. (2005) · The Lancet · doi:10.1016/s0140-6736(05)67139-5 · Cited by 1,541
Self-citationGerm-Line Mutations in Nonsyndromic Pheochromocytoma
Neumann, H. P. H., Bausch, B., McWhinney, S. R., Bender, B., Gimm, O., Franke, G., Schipper, J., Klisch, J., Altehoefer, C., Zerres, K., et al. (2002) · New England Journal of Medicine · doi:10.1056/nejmoa020152 · Cited by 1,350
Biochemical Diagnosis of Pheochromocytoma: Which Test Is Best?
Lenders, J. W. M., Pacak, K., Walther, M. M., Linehan, W. M., Mannelli, M., Friberg, P., Keiser, H. R., Goldstein, D. S., & Eisenhofer, G. (2002) · JAMA · doi:10.1001/jama.287.11.1427 · Cited by 1,134
Self-citationGenetic Testing in Pheochromocytoma or Functional Paraganglioma
Amar, L., Bertherat, J. Y., Baudin, É., Ajzenberg, C., Paillerets, B. B., Chabre, O., Chamontin, B., Delemer, B., Giraud, S., Murat, A., et al. (2005) · Journal of Clinical Oncology · doi:10.1200/jco.2005.03.1484 · Cited by 683
Pheochromocytoma: recommendations for clinical practice from the First International Symposium
Pacák, K., Eisenhofer, G., Ahlman, H., Bornstein, S. R., Gimenez‐Roqueplo, A., Grossman, A. B., Kimura, N., Mannelli, M., McNicol, A. M., & Tischler, A. S. (2007) · Nature Clinical Practice Endocrinology & Metabolism · doi:10.1038/ncpendmet0396 · Cited by 675
Self-citationSDHA is a tumor suppressor gene causing paraganglioma
Burnichon, N., Brière, J.-J., Libé, R., Vescovo, L., Rivière, J., Tissier, F., Jouanno, E., Jeunemaı̂tre, X., Bénit, P., Tzagoloff, A., et al. (2010) · Human Molecular Genetics · doi:10.1093/hmg/ddq206 · Cited by 645
van Nederveen, F. H., Gaal, J., Favier, J., Korpershoek, E., Oldenburg, R. A., de Bruyn, E. M., Sleddens, H. F. B. M., Derkx, P., Rivière, J., Dannenberg, H., et al. (2009) · The Lancet Oncology · doi:10.1016/s1470-2045(09)70164-0 · Cited by 554
Self-citationEisenhofer, G., Goldstein, D. S., Stull, R., Keiser, H. R., Sunderland, T., Murphy, D. L., & Kopin, I. J. (1986) · Clinical Chemistry · doi:10.1093/clinchem/32.11.2030 · Cited by 477
Self-citationGermline mutations in TMEM127 confer susceptibility to pheochromocytoma
Qin, Y., Yao, L., King, E. E., Buddavarapu, K., Lenci, R. E., Chocron, E. S., Lechleiter, J. D., Sass, M., Aronin, N., Schiavi, F., et al. (2010) · Nature Genetics · doi:10.1038/ng.533 · Cited by 379
Eisenhofer, G., Lenders, J. W. M., Linehan, W. M., Walther, M. M., Goldstein, D. S., & Keiser, H. R. (1999) · New England Journal of Medicine · doi:10.1056/nejm199906173402404 · Cited by 346
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Pheochromocytoma and paraganglioma: an endocrine society clinical practice guideline
Lenders, J. W. M., Duh, Q.-Y., Eisenhofer, G., Gimenez-Roqueplo, A.-P., Grebe, S. K. G., Murad, M. H., Naruse, M., Pacak, K., & Young, W. F. (2014) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2014-1498 · Cited by 2,827
Self-citationComprehensive Molecular Characterization of Pheochromocytoma and Paraganglioma
Fishbein, L. M., Leshchiner, I., Walter, V., Danilova, L., Robertson, A. G., Johnson, A. R., Lichtenberg, T. M., Murray, B. A., Ghayee, H. K., Else, T., et al. (2017) · Cancer Cell · doi:10.1016/j.ccell.2017.01.001 · Cited by 817
Pheochromocytoma and Paraganglioma
Neumann, H. P. H., Young, W. F., & Eng, C. (2019) · New England Journal of Medicine · doi:10.1056/nejmra1806651 · Cited by 736
Update on Adrenal Tumours in 2017 World Health Organization (WHO) of Endocrine Tumours
Lam, A. K.-Y. (2017) · Endocrine Pathology · doi:10.1007/s12022-017-9484-5 · Cited by 463
Personalized Management of Pheochromocytoma and Paraganglioma
Nölting, S., Bechmann, N., Taïeb, D., Beuschlein, F., Faßnacht, M., Kroiß, M., Eisenhofer, G., Grossman, A. B., & Pacák, K. (2021) · Endocrine Reviews · doi:10.1210/endrev/bnab019 · Cited by 441
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Metadata
- Authors
- Eisenhofer, G., Lenders, J. W., Timmers, H., Mannelli, M., Grebe, S. K., Hofbauer, L. C., Bornstein, S. R., Tiebel, O., Adams, K., Bratslavsky, G., Linehan, W. M., & Pacak, K.
- Affiliations
- Technische Universität Dresden (DE)
- Radboud University Nijmegen (NL)
- University of Florence (IT)
- Mayo Clinic (US)
- Institute of Clinical Chemistry and Laboratory Medicine and
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (US)
- National Institutes of Health (US)
- Reproductive and Adult Endocrinology Program, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD
- Corresponding author
- Eisenhofer, Graeme
- ORCID
- Venue
- Clinical Chemistry
- Publisher
- Oxford University Press (OUP)
- Published
- 2011-03-01
- Volume
- 57
- Issue
- 3
- Pages
- 411-420
- ISSN
- 0009-9147 (ISSN-L)
- 1530-8561
- PMC
- PMC3164998
- OpenAlex
- W2163960412
- Cited by
- 290
- References
- 35
- Citations by year
- 2025: 6 · 2024: 6 · 2023: 15 · 2022: 16 · 2021: 20 · 2020: 16 · 2019: 16 · 2018: 17 · 2017: 32 · 2016: 19 · 2015: 32 · 2014: 31 · 2013: 27 · 2012: 22
- FWCI
- 30.48
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- Clinical Chemistry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Site cant be reached (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Funders
- Deutsche Forschungsgesellschaft
- Center for Regenerative Therapies Dresden
- Dresden Tumor Center
- Eunice Kennedy Shriver National Institute of Child Health and Human Development
- Center for Cancer Research
- National Cancer Institute
- 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, familial pheochromocytoma, methoxytyramine, normetanephrine, metanephrine, von Hippel-Lindau disease, SDHB mutation, SDHD mutation, multiple endocrine neoplasia type 2, neurofibromatosis type 1, genotyping, epinephrine, norepinephrine, dopamine
- MeSH terms
- Adrenal Gland Neoplasms, Diagnosis, Differential, Dopamine, Humans, Metanephrine, Neoplastic Syndromes, Hereditary, Normetanephrine, Pheochromocytoma, Retrospective Studies, Biomarkers, Tumor
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