Endocrinol Metab.  2021 Jun;36(3):697-701. 10.3803/EnM.2020.925.

Urinary Free Metanephrines for Diagnosis of Pheochromocytoma and Paraganglioma

• Ahn J
• Park JY
• Kim G
• Jin SM
• Hur KY
• Lee SY
• Kim JH

• KMID: 2517660
• DOI: http://doi.org/10.3803/EnM.2020.925

Abstract

Background
Pheochromocytoma and paraganglioma (PPGL) is diagnosed through biochemical confirmation of excessive catecholamines in urine and plasma. Recent technological developments have allowed us to measure urinary free metanephrines; however, the diagnostic accuracy of these new methods and the diagnostic cutoff values have not been evaluated.
Methods
This is a retrospective study of 595 subjects, including 71 PPGL cases and 524 controls. PPGL was based on pathological confirmation. Subjects with no evidence of PPGL over 2 years were included in the control group.
Results
Urinary free metanephrines yielded similar area under the curve (AUC) to urinary fractionated metanephrines and plasma free metanephrines. However, urinary free normetanephrine yielded a better AUC than did urinary fractionated normetanephrine. The optimal cutoff for urinary free metanephrine and normetanephrine corrected for urinary creatinine yielded 97.2% sensitivity and 98.1% specificity.
Conclusion
Urinary free metanephrines are a reliable method for diagnosing PPGL in Asian populations compared with existing biochemical methods.

Keyword

Metanephrine; Normetanephrine; Pheochromocytoma; Paraganglioma

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