Biochemical Tests for Pheochromocytoma: Strategies in Hypertensive Patients.
OBJECTIVE: To determine the optimal clinical strategy utilizing either 1) serum catecholamines, 2) urinary metanephrines, or 3) urinary vanillylmandelic acid measurements in the evaluation of hypertensive patients with suspected pheochromocytoma.
DESIGN: Prospective clinical determination of test-operating characteristics.
SETTING: Tertiary care university medical center.
PATIENTS/PARTICIPANTS: 415 patients referred for evaluation of suspected pheochromocytoma.
INTERVENTIONS: All subjects had measurements of the three above-mentioned biochemical tests with the diagnosis of pheochromocytoma established by tissue confirmation.
RESULTS: All three biochemical tests were similar in sensitivity (0.70-0.75), specificity (0.90-0.95), and receiver operating characteristics. With an estimated disease prevalence of 5.9% in symptomatic hypertensive patients, the predictive value of any single negative test would be 98% in ruling out disease.
CONCLUSIONS: All three biochemical tests have similar performance characteristics and only a single test need be performed to exclude pheochromocytoma in most symptomatic hypertensive patients in a primary care population.
Published In/Presented At
Young, M. J., Dmuchowski, C., Wallis, J. W., Barnas, G. P., & Shapiro, B. (1989). Biochemical tests for pheochromocytoma: strategies in hypertensive patients. Journal Of General Internal Medicine, 4(4), 273-276.
Medical Sciences | Medicine and Health Sciences
Department of Medicine, Department of Medicine Faculty