2002), increase of urinary excretion of normetanephrine
, a methylated breakdown product of norepinephrine, which indicates MAO inhibition (Riba et al.
Measurements of plasma methoxytyramine, normetanephrine
, and metanephrine as discriminators of different hereditary forms of pheochromocytoma.
Postoperatively his plasma-free metanephrines showed a normetanephrine
still elevated at 295 (n < 148), and the metanephrine and chromogranin A were normal.
Subsequently, urinary free cortisol (UFC) (normal range: <110[micro]g), urinary normetanephrine
(normal range: 88-444 [micro]g/day) and urinary metanephrine (normal range: 52-341 [micro]g/day) were measured and the 1 mg overnight dexamethasone suppression test (DST) was performed.
dehydroepiandrosterone sulfate (DHEA-S), serum baseline 17-hydroxyprogesterone (17-0HP), urinary metanephrine, normetanephrine
, vanilylmandelic acid (VMA) excretion, low-dose 2 mg dexamethasone suppression tests, plasma aldosterone and renin activity.
Subjects that met DSM-III criteria for a major depressive episode with melancholia, characterized by irrational fears, guilt, and apathy, exhibited significantly higher urinary outputs of normetanephrine
5 mg (normal 0-7), metanephrine 129 mg (normal 30-300), normetanephrine
378 mg (normal 50-600), calcium 352 mg (normal 50-300), chlorine 149 mEq (normal 110-250), potassium 113.
Adrenal endocrine hormones, including plasma and urine cortisol, plasma metanephrine and normetanephrine
(MN and NMN), plasma aldosterone, renin and sex hormones, were also examined.
Initial results showed borderline increases in plasma normetanephrine
(NMN) and metanephrine (MN) that were not diagnostic of pheochromocytoma (PCC).
The increase in normetanephrine
is in line with MAO inhibition.
3 Urine epinephrine ([micro]g/24 h) 2-24 395 Urine norepinephnne ([micro]g/24 h) 15-100 281 Urine dopamine ([micro]g/24 h) 52-480 4,095 Urine normetanephrine
([micro]g/24 h) 52-310 10,649 Urine metanephrine ([micro]g/24 h) 19-140 36,310
Tests can determine levels of dexamethasone suppression; 24-hour urinary free cortisol; urinary 17-hydroxycortisol and 17-ketosteroid; plasma androgens, testosterone, androstenedione, renin, and aldosterone; urinary vanillylmandelic acid; plasma catecholamines; and plasma metanephrine and normetanephrine