Urine catecholamine levels as diagnostic markers for neuroblastoma in a defined population: implications for ophthalmic practice

Abstract

Purpose Although elevated urinary catecholamine levels have been reported in 90–95% of patients with neuroblastoma, more recent studies of pediatric Horner syndrome caused by an underling neuroblastoma have reported normal values at presentation. The purpose of this population-based study is to report the percentage of cases of neuroblastoma with elevated urinary catecholamine levels at presentation and to suggest a recommended work-up for cases of idiopathic pediatric Horner syndrome. Methods The medical records of all pediatric (< 19 years) residents of Olmsted County, Minnesota diagnosed with neuroblastoma from January 1, 1969, through December 31, 2008, were retrospectively reviewed. Results A total of 14 patients < 19 years of age were diagnosed with neuroblastoma as residents of Olmsted County, Minnesota, during the 40-year study period. Ten (71%) of the 14 cases manifested elevated urinary catecholamine metabolites at the initial presentation. Urinary vanillylmandelic acid (VMA) levels were greater than twice the upper limit of normal in 8 (57%) of 14 cases, while homovanillic acid (HVA) levels were greater than 2 times the upper limit of normal in 10 (71%) of the 14 cases. Three (75%) of the 4 cases without significantly elevated urinary VMA or HVA levels were diagnosed with stage IV disease, while 1 (25%) had stage II neuroblastoma. Conclusion Urinary catecholamine levels were significantly elevated at presentation in 10 (71%) of the 14 neuroblastoma cases during the 40-year study period, suggesting that greater emphasis be placed on performing a thorough physical examination and obtaining warranted imaging studies in cases of idiopathic pediatric Horner syndrome.

Determination of catecholamines and their metabolites in rat urine by ultra‐performance liquid chromatography–tandem mass spectrometry for the study of identifying potential markers for Alzheimer's disease

“…1, some aldehyde compounds in the body are not stable and transformed to others quickly, just the 14 kinds of CAs can be measured; so, the quantitation of the 14 kinds of CAs concentrations in biological specimens is useful as an index for several diseases, for example, Alzheimer's disease, [5][6][7] hypertension, [8,9] pheochromocytoma [10,11] and neuroblastoma. [4,12,13] Several reports have illustrated that the level of CAs and their metabolites in body fluids is different between normal people and patients with Alzheimer's disease (AD). [5,14] Collecting cerebrospinal fluid or plasma can be invasive, so urine may be a good selection.…”

Clinico-pathological patterns of a rare presentation of abdominal neuroblastoma in children

“…[15] Sharp found that urinary VMA was elevated in 63% of the tested children and 60% of patients have metastatic disease. [16] Berthold et al…”

Horner Syndrome in Children: A Clinical Condition with Serious Underlying Disease

“…However, because urine catecholamine studies have been normal in a few children with neuroblastoma, as in our patient, further investigations are often needed to exclude tumoral lesion. 15 Finally, metaiodobenzylguanidine scintigraphy is out of the initial radiological approach. Nevertheless, it is an interesting technique to characterize the nature of a neck or chest mass in pediatric population when neuroblastoma is suspected.…”