Consideration of the degree of increase in urine metadrenalines provides superior specificity in the diagnosis of phaeochromocytoma than additional urine catecholamine measurement
Autor: | J W Kane, Paul Reed, J J Scargill |
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Rok vydání: | 2013 |
Předmět: |
Male
medicine.medical_specialty endocrine system diseases Screening test Clinical Biochemistry Urine catecholamines Adrenal Gland Neoplasms Urology Diagnostic Specificity Pheochromocytoma Urine Sensitivity and Specificity Catecholamines Reference Values Internal medicine medicine Humans Chromatography High Pressure Liquid Metanephrine business.industry General Medicine Catecholamines urine Predictive value Endocrinology Current practice Female business Urine catecholamine measurement |
Zdroj: | Annals of Clinical Biochemistry: International Journal of Laboratory Medicine. 50:73-75 |
ISSN: | 1758-1001 0004-5632 |
DOI: | 10.1258/acb.2012.012083 |
Popis: | Background Measurement of fractionated plasma or urine metadrenalines is the recommended screening test in the diagnosis of phaeochromocytoma, with clinical cut-offs geared towards diagnostic sensitivity. Current practice at Salford Royal Hospital is to add urine catecholamines onto samples with raised urine metadrenalines, with the aim of adding specificity to a diagnosis of phaeochromocytoma. Methods This practice was reviewed by identifying a series of patients with raised urine metadrenalines who had catecholamines reflectively added. A total of 358 samples were identified from 242 patients, of which 228 had urine catecholamines measured. Results A diagnosis of ‘phaeochromocytoma‘ (n = 41) or ‘no phaeochromocytoma‘ (n = 90) was obtained in 131 of 228 patients, giving raised urine metadrenalines a positive predictive value for phaeochromocytoma of 31%. The finding of increased urine catecholamines in samples with raised urine metadrenalines increased specificity for phaeochromocytoma to 70%. However, 95% diagnostic specificity for phaeochromocytoma could be achieved by the introduction of a second cut-off for urine metadrenalines geared towards maximizing specificity. Conclusions Consideration of the degree of increase in urine metadrenalines is a superior method of determining the likelihood of phaeochromocytoma than measurement of urine catecholamines. |
Databáze: | OpenAIRE |
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