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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.
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.
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 and dopamine.
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.