[Plasma methoxyamines assay: a practical advance for the diagnosis of pheochromocytoma]

Pathol Biol (Paris). 1994 Nov;42(9):847-54.
[Article in French]

Abstract

Measurement of plasma methoxyamines is aimed to provide a reliable plasma marker readily available for any patient suspected of having a pheochromocytoma. The present HPLC method is able to detect methoxyamine amounts as low as 0.2 nmoles/l and allows the determination of both free or conjugated methoxyamines (metanephrine MN and normetanephrine NMN) in normal subjects, treated or untreated patients and a fortiori in pheochromocytoma. The analytical specificity is excellent. Among most usual antihypertensive drugs, only conversion enzyme inhibitors and diuretics induce in some patients a moderate increase of NMN with minor consequence in values interpretation. The kidney plays a major role in the blood clearance of methoxyamines and any alteration of renal function is associated to the increase of plasma methoxyamine levels. Plasma methoxyamines have a long half-life and are long-lasting integrated markers of catecholamine secretion; at variance with plasma free catecholamines, they are able to afford the presence of a secreting pheochromocytoma whatever the clinical presentation--asymptomatic or paroxysmal form between the crisis. The diagnostic sensitivity (at least 98%) is equal to that of urinary methoxyamines, far higher than plasma or urine catecholamines or urine VMA (60 to 70%).

Publication types

  • Comparative Study
  • English Abstract

MeSH terms

  • Adrenal Gland Neoplasms / blood
  • Adrenal Gland Neoplasms / diagnosis*
  • Adrenal Gland Neoplasms / surgery
  • Adult
  • Aged
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Chromatography, High Pressure Liquid
  • Diuretics / therapeutic use
  • Female
  • Humans
  • Hypertension / blood*
  • Hypertension / drug therapy
  • Male
  • Metanephrine / blood*
  • Middle Aged
  • Normetanephrine / blood*
  • Pheochromocytoma / blood
  • Pheochromocytoma / diagnosis*
  • Pheochromocytoma / surgery
  • Reference Values
  • Renal Insufficiency / blood

Substances

  • Angiotensin-Converting Enzyme Inhibitors
  • Diuretics
  • Normetanephrine
  • Metanephrine