Do synthetic adrenergic agents interfere with the measurement of endogenous plasma catecholamine concentrations?

Weissman, Charles; Jamdar, Subhash C.; Soo, E.

doi:10.1016/0883-9441(95)90019-5

Cited by 5 publications

(2 citation statements)

References 21 publications

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“…This important issue must be taken into account when comparing the results of different methods, 17 or when examining the catecholamine plasma levels (using the HPLC method) from patients receiving sympathomimetic and sympatholytic agents in the intensive care unit and operating room 19 . Recent reports on the determination of plasma‐free metanephrines by HPLC have shown an interference with paracetamol 20 …”

Section: Discussionmentioning

confidence: 99%

Multicenter Study on the Diagnostic Value of a New RIA for the Detection of Free Plasma Metanephrines in the Work‐Up for Pheochromocytoma

Lenz

Zorner

Kirchmaier

et al. 2006

Annals of the New York Academy of Sciences

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Available laboratory test methods for the detection of elevated concentrations of catecholamines and their metabolites in urine and/or plasma are not always sensitive enough for the detection of pheochromocytoma. High-quality immunoassays for these compounds appear to be as accurate as high-pressure liquid chromatography (HPLC) or gas chromatography/mass spectrometry (GC-MS). Therefore, the current project aims to establish a new sensitive radioimmunoassay (RIA) for the measurement of free metanephrines in the plasma of patients in the work-up for pheochromocytoma. We report first results of an ongoing multicenter clinico-chemical evaluation study in hypertensive patients and normotensive volunteers. After an overnight fast plasma samples were collected on ice in EDTA- and heparin-coated tubes after insertion of an indwelling venous line and resting in the supine (patients) or sitting position (normal volunteers) for 30 min. Plasma metanephrines were measured by a newly developed RIA from IBL, Hamburg, Germany. Good agreement of the assay with the tandem mass spectrometry (LC-MS/MS) method for normetanephrine (r2=0.975) and for metanephrine (r2=0.985) could be demonstrated. Both specimens, EDTA and heparin plasma, can be used with the same results. The RIA has a good precision of <15% in the normal range and of <10% in the elevated concentration range. Our preliminary data suggest a high validity of the newly developed RIA for measuring free metanephrine and normetanephrine in hypertensive subjects in both EDTA and heparin plasma. Further work is required to determine the accuracy of the test in larger patient populations and in patients with pheochromocytoma.

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Section: Discussionmentioning

confidence: 99%

Multicenter Study on the Diagnostic Value of a New RIA for the Detection of Free Plasma Metanephrines in the Work‐Up for Pheochromocytoma

Lenz

Zorner

Kirchmaier

et al. 2006

Annals of the New York Academy of Sciences

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“…One of the most common pharmaco-physiological causes of falsepositive test results during diagnosis of PPGLs involves the effect of tricyclic antidepressants and related drugs to block sympathoneuronal reuptake of noradrenaline and thereby increase plasma and urinary concentrations of the amine and its metabolites. [1][2][3][4] Direct analytical interferences with high-performance liquid chromatography electrochemical detection (HPLC-ECD)-based measurements of plasma or urinary catecholamines and their O-methylated metabolites can result from numerous medications, including labetolol, 5,6 buspirone, 7 acetaminophen, 8,9 mesalamine 10 and its prodrug, sulphasalazine. 11 While pharmaco-physiological causes of false-positive results during diagnosis of PPGLs are method independent, those involving analytical interferences are usually method and analyte specific.…”

Section: Introductionmentioning

confidence: 99%

Levodopa therapy in Parkinson’s disease: influence on liquid chromatographic tandem mass spectrometric-based measurements of plasma and urinary normetanephrine, metanephrine and methoxytyramine

Eisenhofer

Brown²,

Peitzsch

et al. 2013

Ann Clin Biochem

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Diagnosis of Pheochromocytoma

Lenz

Goßmann²,

Schulte³

et al. 1988

N Engl J Med

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THE multiplicity of pharmacologic tests for elevations of 10 millimeters of mercury or less aheochromocytoma and the occurrence of were found in 6 of 86 patients reported by Graham, False positive and false negative results, with but maximal systolic elevations of such small degree consequent indecision as to diagnostic standards, were observed by him only once. One patient recall for a reappraisal of diagnostic requirements.ported by McCullagh and Engel 3 with paroxysms The volume of writing about this disease is mis-of symptoms had normal blood pressure during leading because it is disproportionate to the some attacks of sweating and hypertension at other number of cases seen. Viewed statistically, the times. Therefore, a specific degree of blood preslikelihood of finding a pheochromocytoma in a sure elevation cannot be used as a prerequisite for patient seen in consultation because the presence diagnosis. of this tumor is suspected is indeed small. Of 259 patients referred to Gifford, Roth and Kvale 1 for ESTS testing to rule out pheochromocytoma as the cause Te ost reliable evidence of pheochromocytoma of hypertension or other symptoms, only 7 had the demonstration of excessive amounts of pheochromocytomas, although 239 had hypertenpressr substances in the blood, particularly if sion. Graham 2 stated that only 8 patients were circulating epinephrine and nor-epinephrine can be found in 1,700 unselected patients with hyperdifferentiated (since pheochromocytomas secrete tension subjected to bilateral lumbodorsal splanchmore nor-epinephrine). Excessive amounts of unnicectomy during which the adrenals and the paradifferentiated pressor substance in the circulation vertebral areas were routinely examined. Many of are not necessarily diagnostic of pheochromocytoma the symptoms experienced by patients with pheo-ce diseases easily confused with pheochroIosince diseases easily confused with pheochromolcromocytoma are found in more commonly seen cytoma may be accompanied by increased amounts diseases-notably, essential hypertension, "neuof circulating epinephrine resulting from neural rogenic" hypertension and severe anxiety attacks, stimulation of the adrenal medulla. At any rate, and spontaneous hypoglycemia.reliable chemical tests are rarely available. Many, Important clinical signposts which may lead to indeed confusingly many, pharmacologic tests a diagnosis are manifestation of epinephrine action have been used to confirm the clinical diagnosis of -profuse and also almost continuous sweating, palpheochromocytoma. All have yielded false positive pitation and tachycardia, dilated pupils and, of and false negative results; and several of the tests course, hypertension. Not all of these manifestamentioned in the literature have become outmoded tions need be present. When hypertension is by safer and more fruitful procedures. sustained, paroxysmal symptoms are usually absent.In general these tests can be separated into two However, questioning may reveal that the patient groups-those which are designed to lower an has ...

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Do synthetic adrenergic agents interfere with the measurement of endogenous plasma catecholamine concentrations?

Cited by 5 publications

References 21 publications

Multicenter Study on the Diagnostic Value of a New RIA for the Detection of Free Plasma Metanephrines in the Work‐Up for Pheochromocytoma

Multicenter Study on the Diagnostic Value of a New RIA for the Detection of Free Plasma Metanephrines in the Work‐Up for Pheochromocytoma

Levodopa therapy in Parkinson’s disease: influence on liquid chromatographic tandem mass spectrometric-based measurements of plasma and urinary normetanephrine, metanephrine and methoxytyramine

Diagnosis of Pheochromocytoma

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