Plasma metanephrines: a novel and cost-effective test for pheochromocytoma

被引:30
作者
Eisenhofer, G
Walther, M
Keiser, HR
Lenders, JWM
Friberg, P
Pacak, K
机构
[1] NINDS, Clin Neurocardiol Sect, NIH, Bethesda, MD 20892 USA
[2] NCI, Urol Oncol Branch, NIH, Bethesda, MD 20892 USA
[3] NHLBI, Hypertens Endocrine Branch, NIH, Bethesda, MD 20892 USA
[4] Univ Nijmegen St Radboud Hosp, Dept Gen Internal Med, NL-6500 HB Nijmegen, Netherlands
[5] Univ Gothenburg, Dept Clin Physiol, Gothenburg, Sweden
关键词
pheochromocytoma; hypertension; sympathetic nervous system; adrenal gland; metanephrines; catecholamines;
D O I
10.1590/S0100-879X2000001000005
中图分类号
Q [生物科学];
学科分类号
07 ; 0710 ; 09 ;
摘要
Pheochromocytomas are rare chromaffin cell tumors that nevertheless must be excluded in large numbers of patients who develop sustained or episodic hypertension as well as in many others with suggestive symptoms or with a familial history of pheochromocytoma. Diagnosis of pheochromocytoma depends importantly on biochemical evidence of excess catecholamine production by a tumor. Imperfect sensitivity and specificity of commonly available biochemical tests and the low incidence of the tumor among the tested population mean that considerable time and effort can be expended in confirming or ruling out pheochromocytoma in patients where the tumor is suspected. Measurements of plasma free metanephrines provide a superior test compared to other available tests for diagnosis of pheochromocytoma. In particular, the high sensitivity of plasma free metanephrines means that a normal test result reliably excludes all but the smallest of pheochromocytomas so that no other tests are necessary. Measurements of plasma free metanephrines, when systematically combined with other diagnostic procedures outlined in this review, provide a more efficient, reliable and cost-effective approach for diagnosis of pheochromocytoma than offend by previously available approaches.
引用
收藏
页码:1157 / 1169
页数:13
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