All the catecholamines and metabolites appear to be increasing with the urine collections. Firstly one should examine the 24h creatinine results to ascertain that all the collections are for the same time period.
The predominant increase is in HVA, the metabolite of dopamine. This patient is on Moxonidine, which acts on alpha2adrenoreceptor and doxazocin which is an alpha blocker. These drugs or the combination may act as dopamine antagonists.
I suggest that both these drugs be stopped and the 24h urine collections be repeated off medication.
Dr Jeffrey Barron
Department of Chemical Pathology
St Helier Hospital
Carshalton Surrey SM5 1AA
UK
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Tel 0181 296 2660
Fax 0181 641 2633
Fax 0181 641 2633
0181 296 2660
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