The challenge of improving the diagnostic yield from metanephrine testing in suspected phaeochromocytoma and paraganglioma
Background Plasma-free metanephrines (PFM) or urinary fractionated metanephrines (UFM) are the preferred biochemical tests for the diagnosis of phaeochromocytoma and paraganglioma (PPGL). Borderline increased results should be followed up to either exclude or confirm diagnosis. Methods We extracted...
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| Format: | Article |
| Language: | English |
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Sage Publications
2018
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| Online Access: | http://psasir.upm.edu.my/id/eprint/74117/ http://psasir.upm.edu.my/id/eprint/74117/1/The%20challenge%20of%20improving%20the%20diagnostic%20yield%20from%20metanephrine%20testing%20in%20suspected%20phaeochromocytoma%20and%20paraganglioma.pdf |
| _version_ | 1848857436809592832 |
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| author | Samsudin, Intan Nureslyna Page, Michael M. Hoad, Kirsten Chubb, Paul Gillett, Melissa Glendenning, Paul Vasikaran, Samuel |
| author_facet | Samsudin, Intan Nureslyna Page, Michael M. Hoad, Kirsten Chubb, Paul Gillett, Melissa Glendenning, Paul Vasikaran, Samuel |
| author_sort | Samsudin, Intan Nureslyna |
| building | UPM Institutional Repository |
| collection | Online Access |
| description | Background Plasma-free metanephrines (PFM) or urinary fractionated metanephrines (UFM) are the preferred biochemical tests for the diagnosis of phaeochromocytoma and paraganglioma (PPGL). Borderline increased results should be followed up to either exclude or confirm diagnosis. Methods We extracted all PFM and UFM results reported by our laboratory over a six-month period from the laboratory information system. We categorized patients with borderline increased results according to whether follow-up testing had been performed as suggested in the initial laboratory report. Questionnaires were then sent to all requesting doctors and medical notes reviewed where available. Results Two hundred and four patients with borderline increased PFM or UFM were identified. Sixty-five (38.5%) of 169 patients with borderline increased PFM had a repeat test out of which 36 were normal and 29 did not normalize. Of 35 patients with borderline increased UFM, 17 (48.6%) had subsequent PFM measurement, out of which 15 were normal. Questionnaires were returned to 106 (52%) patients. Of these, the most frequent indication for testing was hypertension ( n = 50); 15 patients had an incidental adrenal mass and two of these patients were diagnosed with a phaeochromocytoma. Conclusion Only 38% of patients with borderline increased PFM had a repeat PFM measurement. This was not significantly higher when compared with the 28% in a previous audit that we reported in 2010 ( P = 0.10). Forty-nine per cent of patients with a borderline increased UFM had a repeat UFM or PFM measurement. There remains a substantial possibility of missed detection of PPGL. |
| first_indexed | 2025-11-15T11:57:32Z |
| format | Article |
| id | upm-74117 |
| institution | Universiti Putra Malaysia |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-15T11:57:32Z |
| publishDate | 2018 |
| publisher | Sage Publications |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | upm-741172020-04-26T19:05:17Z http://psasir.upm.edu.my/id/eprint/74117/ The challenge of improving the diagnostic yield from metanephrine testing in suspected phaeochromocytoma and paraganglioma Samsudin, Intan Nureslyna Page, Michael M. Hoad, Kirsten Chubb, Paul Gillett, Melissa Glendenning, Paul Vasikaran, Samuel Background Plasma-free metanephrines (PFM) or urinary fractionated metanephrines (UFM) are the preferred biochemical tests for the diagnosis of phaeochromocytoma and paraganglioma (PPGL). Borderline increased results should be followed up to either exclude or confirm diagnosis. Methods We extracted all PFM and UFM results reported by our laboratory over a six-month period from the laboratory information system. We categorized patients with borderline increased results according to whether follow-up testing had been performed as suggested in the initial laboratory report. Questionnaires were then sent to all requesting doctors and medical notes reviewed where available. Results Two hundred and four patients with borderline increased PFM or UFM were identified. Sixty-five (38.5%) of 169 patients with borderline increased PFM had a repeat test out of which 36 were normal and 29 did not normalize. Of 35 patients with borderline increased UFM, 17 (48.6%) had subsequent PFM measurement, out of which 15 were normal. Questionnaires were returned to 106 (52%) patients. Of these, the most frequent indication for testing was hypertension ( n = 50); 15 patients had an incidental adrenal mass and two of these patients were diagnosed with a phaeochromocytoma. Conclusion Only 38% of patients with borderline increased PFM had a repeat PFM measurement. This was not significantly higher when compared with the 28% in a previous audit that we reported in 2010 ( P = 0.10). Forty-nine per cent of patients with a borderline increased UFM had a repeat UFM or PFM measurement. There remains a substantial possibility of missed detection of PPGL. Sage Publications 2018 Article PeerReviewed text en http://psasir.upm.edu.my/id/eprint/74117/1/The%20challenge%20of%20improving%20the%20diagnostic%20yield%20from%20metanephrine%20testing%20in%20suspected%20phaeochromocytoma%20and%20paraganglioma.pdf Samsudin, Intan Nureslyna and Page, Michael M. and Hoad, Kirsten and Chubb, Paul and Gillett, Melissa and Glendenning, Paul and Vasikaran, Samuel (2018) The challenge of improving the diagnostic yield from metanephrine testing in suspected phaeochromocytoma and paraganglioma. Annals of Clinical Biochemistry, 55 (6). 679 - 684. ISSN 0004-5632; ESSN: 1758-1001 10.1177/0004563218774590 |
| spellingShingle | Samsudin, Intan Nureslyna Page, Michael M. Hoad, Kirsten Chubb, Paul Gillett, Melissa Glendenning, Paul Vasikaran, Samuel The challenge of improving the diagnostic yield from metanephrine testing in suspected phaeochromocytoma and paraganglioma |
| title | The challenge of improving the diagnostic yield from metanephrine testing in suspected phaeochromocytoma and paraganglioma |
| title_full | The challenge of improving the diagnostic yield from metanephrine testing in suspected phaeochromocytoma and paraganglioma |
| title_fullStr | The challenge of improving the diagnostic yield from metanephrine testing in suspected phaeochromocytoma and paraganglioma |
| title_full_unstemmed | The challenge of improving the diagnostic yield from metanephrine testing in suspected phaeochromocytoma and paraganglioma |
| title_short | The challenge of improving the diagnostic yield from metanephrine testing in suspected phaeochromocytoma and paraganglioma |
| title_sort | challenge of improving the diagnostic yield from metanephrine testing in suspected phaeochromocytoma and paraganglioma |
| url | http://psasir.upm.edu.my/id/eprint/74117/ http://psasir.upm.edu.my/id/eprint/74117/ http://psasir.upm.edu.my/id/eprint/74117/1/The%20challenge%20of%20improving%20the%20diagnostic%20yield%20from%20metanephrine%20testing%20in%20suspected%20phaeochromocytoma%20and%20paraganglioma.pdf |