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🌱 來自: pheochromocytoma

Diagnostic studies of pheochromocytoma

(JCEM 2014;99:1915)

• 24° urinary fractionated metanephrines:
  • 98% Se,
  • 98% Sp.
  • Screening test of choice if low-risk (b/c false ⊕ with:
    • severe illness,
    • renal failure,
    • OSA,
    • labetalol due to assay interference
    • acetaminophen,
    • TCAs,
    • medications containing sympathomimetics
• Plasma fractionated metanephrines:
  • 97% Se, 91% Sp.
  • Screening test of choice if high risk, but ↑ rate of false ⊕ in low-prevalence population.
  • False ⊕ rate lower if patient supine for 30 min (estimated 2.8× ↑ false ⊕ if seated
• Adrenal CT or T2-weighted MRI;
  • PET for known metastatic disease or to localize nonadrenal mass but usually easy to find;
  • consider MIBG scintigraphy if CT/MRI ⊖
• Consider genetic testing in all Pts (J Intern Med 2019;285:187)