Evaluation of the clonidine suppression test in the diagnosis of phaeochromocytoma

McHenry, Claire; Hunter, Steven; McCormick, M. T.; Russell, C. F. J.; Smye, M.; Atkinson, A. B.

doi:10.1038/jhh.2010.78

Cited by 17 publications

(23 citation statements)

References 21 publications

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“…-If marginally elevated: repeat testing in 6 months or consider clonidine suppression test to exclude false positivity (74,75). f Twenty-four-hour urine fractionated metanephrines are an acceptable alternative to plasma metanephrines once patients are continent of urine.…”

Section: Screening/surveillancementioning

confidence: 99%

Von Hippel–Lindau and Hereditary Pheochromocytoma/Paraganglioma Syndromes: Clinical Features, Genetics, and Surveillance Recommendations in Childhood

Rednam

Erez

Druker

et al. 2017

Clinical Cancer Research

224

157

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Von Hippel-Lindau disease (vHL) is a hereditary tumor predisposition syndrome that places affected individuals at risk for multiple tumors, which are predominantly benign and generally occur in the central nervous system or abdomen. Although the majority of tumors occur in adults, children and adolescents with the condition develop a significant proportion of vHL manifestations and are vulnerable to delayed tumor detection and their sequelae. Although multiple tumor screening paradigms are currently being utilized for patients with vHL, surveillance should be reassessed as the available relevant clinical information continues to expand. We propose a new vHL screening paradigm similar to existing approaches, with important modifications for some tumor types, placing an emphasis on risks in childhood. This includes advancement in the timing of surveillance initiation and increased frequency of screening evaluations. Another neuroendocrine-related familial condition is the rapidly expanding hereditary paraganglioma and pheochromocytoma syndrome (HPP). The tumor spectrum for patients with HPP syndrome includes paragangliomas, pheochromocytomas, renal cancer, and gastrointestinal stromal tumors. The majority of patients with HPP syndrome harbor an underlying variant in one of the SHDx genes (SDHA, SDHB, SDHC, SDHD, SDHA, and SDHAF2), although other genes also have been described (MAX and TMEM127). Annual screening for elevated plasma or urine markers along with complete blood count and biennial whole-body MRI accompanied by focal neck MRI is recommended for older children and adults with HPP syndrome to detect tumors early and to decrease morbidity and mortality from HPP-related tumors.

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Section: Screening/surveillancementioning

confidence: 99%

Von Hippel–Lindau and Hereditary Pheochromocytoma/Paraganglioma Syndromes: Clinical Features, Genetics, and Surveillance Recommendations in Childhood

Rednam

Erez

Druker

et al. 2017

Clinical Cancer Research

224

157

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“…Ein Abfall der Katecholaminplasmakonzentration nach Clonidingabe spricht infolgedessen für eine erhöhte sympathische Aktivität, ein unveränder-ter Wert dagegen für eine autonome Sekretion durch ein P/PGL [3,15]. Die Aussagefähigkeit des CST verbunden mit der Bestimmung der Katecholamine im Plasma ist in mehreren Untersuchungen bestä-tigt worden [9,10,16]. Von einigen Autoren wurde jedoch insbesondere bei normalen oder leicht erhöhten Katecholaminplasmaspiegeln auch über falsch-negative Testergebnisse berichtet [2,9,10,24,26,27].…”

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Die Diagnose des Phäochromozytoms und Paraganglioms

Därr¹,

Lenders

Stange³

et al. 2013

Dtsch med Wochenschr

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“…The following criteria were applied to constitute a positive test using plasma catecholamines by HPLC: baseline plasma ADR and NOR more than 11.82 nmol/l and/or plasma ADR and NOR more than 2.96 nmol/l 3 h after administration of clonidine [5,6].…”

Section: Clonidine Suppression Testingmentioning

confidence: 99%

“…As a regional centre receiving many tertiary cases with abnormal initial tests, we tend to proceed directly to CST for sake of patient convenience. In equivocal cases, our experience in the use of clonidine suppression testing has been excellent over many years [6].…”

Section: Introductionmentioning

confidence: 97%

“…For patients with a high clinical suspicion of phaeochromocytoma and equivocal results after initial biochemical testing, clonidine suppression testing with measurement of plasma catecholamines is very helpful [5,6]. It is based on the principle that clonidine suppresses catecholamine release from sympathetic nerves, but does not affect autonomous tumour production [7].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A comparison of plasma-free metanephrines with plasma catecholamines in the investigation of suspected pheochromocytoma

Lee¹,

Johnston

Atkinson

et al. 2011

Journal of Hypertension

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Plasma metanephrines (metanephrine with NMN) were equally effective as plasma catecholamines during CST. This study supports the use of measuring plasma metanephrines by ELISA as a less labour-intensive and equally effective biochemical test for phaeochromocytoma in patients with a high clinical suspicion. There was still overlap between groups with and without phaeochromocytoma at baseline under controlled conditions and clinically some patients still need to undergo clonidine suppression testing.

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Evaluation of the clonidine suppression test in the diagnosis of phaeochromocytoma

Cited by 17 publications

References 21 publications

Von Hippel–Lindau and Hereditary Pheochromocytoma/Paraganglioma Syndromes: Clinical Features, Genetics, and Surveillance Recommendations in Childhood

Von Hippel–Lindau and Hereditary Pheochromocytoma/Paraganglioma Syndromes: Clinical Features, Genetics, and Surveillance Recommendations in Childhood

Die Diagnose des Phäochromozytoms und Paraganglioms

A comparison of plasma-free metanephrines with plasma catecholamines in the investigation of suspected pheochromocytoma

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