Endocrine Abstracts

Aim: To assess whether using urine catecholamines as a second line investigation has affected clinical decision making in patients with suspected pheochromocytoma and paraganglioma.

The need for the audit: New society of endocrine guidelines in June 14, have recommended using urine metanephrines as the initial screening test for PPGL. Current practise at University Hospital Wales is to offer urine catecholamines as the second line test to patients with a genetic predisposition to pheochromocytoma or those with urine metanephrines above 2/3rd of the upper limit.

Data for the audit: Ten years of data of patients who had both metanephrines and catecholamines checked was obtained from the laboratory computer system. The patients were divided into two groups, one with raised urine metanephrines (55/95 patients) and the other with raised urine catecholamines (40/95 patients). The raised urine metanephrine group included five patients who had both raised metanephrines and raised catecholamines.

Results: • 13% (13/95 patients) with raised metanephrine levels had a diagnosis of PPGL. This included five patients who had both raised metanephrines and catecholamines

• None in the raised catecholamine group alone (40/95 patients), had a diagnosis of PPGL

The audit showed that metanephrines (urine or plasma) alone can be used for diagnosing pheochromocytoma’s and paraganglioma’s.