Plasma Chromogranin A or Urine Fractionated Metanephrines Follow-Up Testing Improves the Diagnostic Accuracy of Plasma Fractionated Metanephrines for Pheochromocytoma

Algeciras‐Schimnich, Alicia; Preissner, Carol M.; Young, William F.; Singh, Ravinder J.; Grebe, Stefan K.

doi:10.1210/jc.2007-1354

Cited by 86 publications

(54 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These methods have different practical advantages and disadvantages, but with the superior analytical specificity achieved with LC-MS/MS methods it can be expected that such methods should also offer improvements in diagnostic specificity. Indeed, a study from the Mayo Clinic, where LC-MS/MS has now replaced LCEC methods, indicated 1 034 positive results for plasma free metanephrines out of a total of 24 204 plasma samples analyzed, yielding a diagnostic specificity of more than 96 % [21]. This compares with previously reported diagnostic specificities for plasma free metanephrines measured by LCEC at the same center of 85 % [9], and at the NIH of 89 % [8].…”

Section: Future Challenges For Effective Diagnosismentioning

confidence: 78%

See 1 more Smart Citation

Current Progress and Future Challenges in the Biochemical Diagnosis and Treatment of Pheochromocytomas and Paragangliomas

Eisenhofer¹,

Siegert²,

Kotzerke³

et al. 2008

Horm Metab Res

View full text Add to dashboard Cite

Findings from five independent studies -with close to 350 patients with pheochromocytoma and more than 2 500 in whom the tumor was excluded -indicate that measurements of plasma free metanephrines provide an overall diagnostic sensitivity of 98 % and specificity of 92 %. The recommendation that initial testing for the tumor should always include measurements of either plasma or urinary fractionated metanephrines results from recognition of the high diagnostic sensitivity of measurements of plasma metanephrines. The few patients with pheochromocytoma in whom the test may not yield a positive result include those with very small tumors or microscopic disease and others with tumors that do not produce norepinephrine and epinephrine. Such patients are typically normotensive and do not exhibit symptoms of catecholamine excess. Additional measurements of methoxytyramine can be useful for detecting those tumors that produce only dopamine. Suboptimal diagnostic specificity and difficulties in distinguishing truefrom false-positive elevations of plasma metanephrines remain challenges for diagnosis. Improvements in analytical technology (e.g., liquid chromatography with tandem mass spectrometry) and new strategies for follow-up testing provide possible solutions to these problems. The single most important remaining clinical care challenge is the development of effective cures for patients with malignant disease. Current treatments, none of which are truly satisfactory, include chemotherapy and radiopharmaceutical therapy with 131 I-labelled miodobenzylguanidine or radioactive somatostatin analogues. Improvements in treatment may in the future come from several fronts, but proof of efficacy ideally will require well-coordinated multicenter prospective trials in larger numbers of patients than in previous studies.

show abstract

Section: Future Challenges For Effective Diagnosismentioning

confidence: 78%

“…This method, however, cannot be used to distinguish false-from true-positive elevations in metanephrine. More recently, a study from the Mayo clinic advocated the use of urine fractionated metanephrines and chromogranin A as follow-up tests [21].…”

Section: Future Challenges For Effective Diagnosismentioning

confidence: 99%

Current Progress and Future Challenges in the Biochemical Diagnosis and Treatment of Pheochromocytomas and Paragangliomas

Eisenhofer¹,

Siegert²,

Kotzerke³

et al. 2008

Horm Metab Res

View full text Add to dashboard Cite

show abstract

“…19 The sympathetic PGLs secrete catecholamines. 19,20 Of the parasympathetic PGLs, most are nonsecretory. The PGLs and PCCs are very rare in children.…”

Section: Hereditary Paraganglioma/ Pheochromocytoma (Pgl/pcc) Syndromesmentioning

confidence: 99%

“…19 The catecholamines secreted by PGLs/PCCs may be epinephrine, norepinephrine, or dopamine. 20 The recommended case detection test is the plasma fractionated metanephrines achieving 82%-97% specificity with 96%-99% of sensitivity. 20 Negative test results exclude the existence of catecholamines.…”

Section: Hereditary Paraganglioma/ Pheochromocytoma (Pgl/pcc) Syndromesmentioning

confidence: 99%

“…Confirmatory testing with plasma chromogranin A or urine fractionated metanephrines is recommended. 20 After confirmatory diagnosis in a proband, molecular genetic testing for succinate dehydrogenase subunit B (SDHB), succinate dehydrogenase subunit C (SDHC), and succinate dehydrogenase subunit D (SDHD) is indicated in all individuals known to have or suspected to have PGL/PCC syndrome. A high index of suspicion should exist for children presenting at early age with bilateral adrenal tumor or with extra-adrenal or multiple tumors.…”

Section: Hereditary Paraganglioma/ Pheochromocytoma (Pgl/pcc) Syndromesmentioning

confidence: 99%

See 1 more Smart Citation

Endocrine causes of systemic hypertension in children and adolescents: a clinical review

Kamboj¹,

Gupta²,

Torres³

et al. 2011

PHMT

View full text Add to dashboard Cite

Hypertension has been well recognized as a major contributor of chronic cardiovascular disease, resulting in significant morbidity and mortality not only in adults but also in children and adolescents. Primary or essential hypertension refers to cases where no underlying etiology is apparent for the high blood pressure, and accounts for a majority of the patients. Secondary hypertension refers to a much smaller group of patients in whom the blood pressure elevation may be attributed to an underlying cause. With improved diagnostic techniques, some cases of previously diagnosed essential hypertension may be found to have an underlying etiology. Endocrine causes account for a relatively small proportion of all patients with hypertension. In the following discussion, only secondary hypertension due to endocrinerelated causes will be discussed.

show abstract

Biochemical Testing for Neuroendocrine Tumors

Vinik

Silva²

2009

Endocrine Pathology:

View full text Add to dashboard Cite

Plasma Chromogranin A or Urine Fractionated Metanephrines Follow-Up Testing Improves the Diagnostic Accuracy of Plasma Fractionated Metanephrines for Pheochromocytoma

Cited by 86 publications

References 19 publications

Current Progress and Future Challenges in the Biochemical Diagnosis and Treatment of Pheochromocytomas and Paragangliomas

Current Progress and Future Challenges in the Biochemical Diagnosis and Treatment of Pheochromocytomas and Paragangliomas

Endocrine causes of systemic hypertension in children and adolescents: a clinical review

Biochemical Testing for Neuroendocrine Tumors

Contact Info

Product

Resources

About