Diagnosis of Pheochromocytoma by Assay of Catecholamine Metabolites

Abstract

Methods for the determination of urinary vanillylmandelic acid (VMA) have been reviewed and variations in VMA excretion in different disease states summarized. The determination of VMA excretion is believed to represent a reliable method for the detection of a pheochromocytoma. Colorimetric screening tests for the detection of elevated VMA excretion have been reviewed and evaluated as laboratory aids in the diagnosis of pheochromocytoma.

Aspects of histamine metabolism

“…The value of measuring urinary metabolites of a biogenic amine that is suspected of a role in diesease was established many years ago. For example, in a study of 45 patients with pheochromocytoma, six had normal urinary levels of norepinephrine but all had abnormally high levels of a norepinephrine metabolite, vanillylmandelic acid (Gitlow et al, 1961). Without the luxury of having a needle in the vein of a patient experiencing a reaction to an endogenous substance, the investigator is reduced to looking at metabolites to make a diagnosis.…”

Urinary Excretion of 3-methoxy-4-hydroxy-mandelic Acid and Banana Feeding

“…The increased excretion of 5-hydroxyindol acetic acid induced by banana feeding observed by Anderson et al (I) and the finding by Waalkes et al (12) about the presence of two potent physiological agents (serotonin and nor adrenaline) in this fruit, as well as the false positive results of 3-methoxy-4-hydroxy-mandelic acid (VMA) excretion that sometitnes may be obtained (5), when high levels of 5-hydroxy indol acetic acid (5-H1AA) are present in the urine, lead to exclude bananas in the patient's diet when a chemical diagnosis of carcinoid, pheochromocytoma or other studies arc desired.…”

Pheochromocytoma: 1. Specificity of Laboratory Diagnostic Tests. 2. Safeguards During Operative Removal

“…Follow-up Studies in 15 Patients Operated at The Mount Sinai Hospital(2)(3)(4)(5)(6)(7)(8)(9)(10)(11) This proved to be a more reliable index of vital organ perfusion than the actual level of the blood pressure. During the recovery phase and prior to discharge from the hospital, the urinary excretion of catecholamine metabolites was assayed.Operative Mortality and MorbidityThere was one death among 15 patients operated upon at the Mount Sinai Hospital.…”