Dear Dr John Earl
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> From: John Earl <[log in to unmask]>
> To: [log in to unmask]
> Subject: Interference in Urinary Catecholamines
> Date: Friday, June 25, 1999 12:34 PM
>
> As part of our protocol for urinary catecholamine collection we have
> always required that urine should not be collected within 24 hours of the
> patient having contrast medium, radioactive gallium for bone scans or
> other nuclear medicine procedures. I must admit I am not entirely sure of
> the scientific reasons behind this. Does anyone have any information ?
>
I am are often confronted with this situation and suggest that the
collection be postponed until the next day for no good scientific reason. I
have always used the excuse that the procedure may be stressful to the
patient and thus raise their urine catecholamines - I have not sure that
this would the case. The other problem "hospital patients" are those who
show an episode of increased BP while under anesthesia and a collection of
urine is started as soon as the operation is over - almost all patients
with elevated urine catecholamines levels on day 1 will show a trend to
levels below the upper reference limit by day three. What advice do you
give to clinicians in regards to the collection of post-op catecholamines?
I know Brett McWhinney has done reference ranges for his ITU patients which
reflect an increased catecholamine excretion in this patient group as a
whole. We never suggest dietary restrictions for our catecholamine
collection preferring that patients collect their urines while on their
normal diet.
Its good to see a bit of activity over this important "needle in the
haystack" , in our neck of the woods aldosterone producing adenomas are far
more common than phaeochromocytomas now-a-days.
Michael Freemantle
Sullivan Nicolaides Pathology
PO Box 344
Indooroopilly Q4068
Brisbane
Australia 4068
ph +61 (0)7 33778638
fax +61 (0)7 38705989
home page http://www.powerup.com.au/~mfreeman
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