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In message <001901bebe23$108902e0$83ecabc3@default>, John O'Connor <[log in to unmask]> writes >We often find slightly elevated urine adrenaline and noradrenaline in >patients who are under investigation for pheochromocytoma but do not have >this condition. Usually the drug history indicates that the patient is >taking some medication that is known to cause mild elevations in the >catecholamines. > >Our reference ranges are based on normotensive patients (should they be as >the majority of patients under investigation are hypertensive?) >Our ranges are as follows >Noradrenaline male <640 nmol/24h; female <470 nmol/24h >Adrenaline male <100 nmol/24h; female <70 nmol/24h >Our protocol is to collect *3, 24h collections on consecutive days. (is this >the best approach) Our reference range (for metanephrines) is based on hypertensive patients as hypertension is usually the indication for testing, and the condition is rarely considered in normotensive individuals (although well described). The other point is that some antihypertensive drugs can elevated urine catecholamines and metabolites although this is probably only a major problem when initiating or changing therapy. No I don't have any canned comments as I find them very difficult and the clinical details are usually minimal - the form is often filled in by nursing staff as they are usually responsible for the collection, giving the patient instructions etc. It is one test that probably generates the highest telephone call rate, as if you don't comment, the clinicians usually phone back anyway ! Trevor Dr. T.A. Gray Department of Clinical Chemistry Northern General Hospital Sheffield S5 7AU 0114 271 4309 %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%