Diagnose pheochromocytoma and those paragangliomas which may secrete epinephrine, norepinephrine, or both. Such tumors may cause paroxysmal or persistent hypertension.
Invert to mix with preservatives immediately after collection
The time between blood collection and the preparation of plasma is quite critical; if the time exceeds one hour, catecholamine values increase (when blood is kept at 4ºC) or decrease (when left at 20ºC).
Dk green heparin (Li or Na), no gel
Frozen (preferred) - 2 weeks
Ambient - 2 hours
High-pressure liquid chromatography (HPLC) with electrochemical (EC) detection
0 to 1 year: 0−659 pg/mL
1 to 18 years: 0−611 pg/mL
18 years and older: 0−874 pg/mL
0 to 1 year: 0−34 pg/mL
1 to 18 years: 0−80 pg/mL
18 years and older: 0−62 pg/mL
0 to 1 year: 0−42 pg/mL
1 to 18 years: 0−32 pg/mL
18 years and older: 0−48 pg/mL
Investigation of hypertensive patients, especially younger individuals, particularly when hypertension is paroxysmal, suggesting pheochromocytoma. Plasma catecholamines with urinary metanephrines and VMA are a recommended test battery for pheochromocytoma.Others recommend plasma catecholamines when urinary collections are not diagnostic. Work up multiple endocrine adenomatosis, type II. Used also in diagnosis of disorders related to the nervous system and in assessment of resuscitation.
The adrenal medullary catecholamines (epinephrine, norepinephrine, and their precursor, dopamine) are rapidly metabolized materials with intense vasoactivity, among many other properties. They can be synthesized by extra-adrenal cells or neoplasms of the APUD system. They are pathogenic in the episodic hypertension of pheochromocytoma, and will be elevated during and immediately after such a paroxysm. However, levels may be normal during asymptomatic intervals. Urine catecholamines, metanephrines, VMA, and HVA provide additive information. A clonidine-suppression test has been described; failure to suppress plasma catecholamines with clonidine supports the diagnosis.