Serum norepinephrine, epinephrine, metanephrine and normetanephrine
levels studied for hypertension aetiology were within normal limits.
For lipids, metanephrine, normetanephrine
, or hemoglobin A1c, there were no differences between the groups.
Blood adrenaline, noradrenaline, metanephrine, normetanephrine
and adrenocorticotropic hormone levels were also normal.
Measurement of plasma free metanephrine and normetanephrine
or 24-h urinary fractionated metanephrines are considered to be the most accurate biochemical tests for pheochromocytoma (4).
Plasma metanephrine levels were normal-to-mildly elevated [metanephrine 0.30 (reference value: 0-0.46 nmol/L); normetanephrine
1.06 (0-0.98 nmol/L); epinephrine 0.73 (0-0.46 nmol/L); norepinephrine 4.45 (0-2.48 nmol/L); domapine <0.2 (0-0.55 nmol/L)].
To exclude pheochromocytoma as a cause of secondary hypertension, 24-h urine metanephrine and normetanephrine
levels were measured and were found to be normal.
The 24-hour urine normetanephrine
level was 141 881 nmol/24 hours.
Preoperative LDH measurement was 422 U/L, VMA was 1.93 mg/day, normetanephrine
was 255.5 [micro]g/24 h, metanephrine was 60.9 [micro]g/24 h, and cortisone was 2.03 [micro]g/dL.
Three years post-resection, a routine endocrinological surveillance test detected elevated urine norepinephrine, normetanephrine
Biochemical tests performed prior to surgery suggested no sign of pheochromocytoma with normal metanephrine, normetanephrine
, and dopamine levels.
Plasma metanephrine and normetanephrine
levels were checked and were within normal limits.
Abdominal MRI and elevated urinary methylated metabolites of catecholamines (Metanephrine = 3.2 [micro]mol / 24h (normal range (NR) 0.2 to 1), Normetanephrine
= 47.5 [micro]mol / 24 h (NR: 0.4 to 2.1)) confirmed the diagnosis of catecholamine-secreting retroperitoneal PG.