Biochemical screening for pheochromocytoma

Biochemical screening for pheochromocytoma

Plasma metanephrines have the highest sensitivity (∼96%), but a low specificity (∼85%), so this test is most appropriate for patients at very high risk (e.g., those with family histories or strong histories and a positive scan).

A 24-hour urine collection for fractionated metanephrines can be recommended for patients at low risk; vanillylmandelic acid (false-positive rate in patients at low risk ∼15%) and total catecholamines can be added for those at higher risk. Collecting a 24-hour urine after a “spell” can increase the sensitivity of urinary tests.


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