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Quantifying urinary catecholamines and metanephrines is essential for the clinical screening and diagnosis of neuroendocrine tumours. HPLC with electrochemical detection (HPLC-ECD) is commonly used for this type of analysis but requires extensive sample cleanup. Simple and rapid dilute-and-shoot LC-multiple-reaction monitoring (MRM)-MS assays have been developed for quantitating these analytes in urine but have not yet been validated according to the Clinical and Laboratory Standards Institute (CLSI) guidelines.

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Pheochromocytoma is a catecholamine-secreting tumor that arises from the medullary chromaffin cells but can rarely be extra-adrenal in origin. We present a case of a 16-year-old female patient with uncontrolled hypertension, despite being on lisinopril and metoprolol, and associated left-sided chest pain, recurrent headaches, and an unintentional weight loss of 10 pounds in one month. Laboratory work-up showed a markedly elevated plasma metanephrine level of 4463.

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Pheochromocytoma is a rare tumor originating from the adrenal gland, characterized by the secretion of catecholamines. Due to the risk of hypertensive crises associated with catecholamine release, surgical procedures in pheochromocytoma patients are risky. In this case report, laparoscopic appendectomy for acute appendicitis in a patient who has pheochromocytoma will be presented.

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Analysis of Urinary Metanephrines Using Liquid Chromatography Tandem Mass Spectrometry.

Methods Mol Biol

January 2025

Analytic Biochemistry, Calculi and Manual Chemistry, Mass Spectrometry, ARUP Laboratories, Inc., Salt Lake City, UT, USA.

Metanephrines (metanephrine [MN] and normetanephrine [NMN]) are O-methylated metabolites derived from the catecholamines, epinephrine, and norepinephrine, respectively. High concentrations of metanephrines have been observed in individuals with pheochromocytoma, a neuroendocrine tumor. Measurement of metanephrines in urine is used to screen for the tumor.

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A 37-year-old man presented with symptoms of polyuria and weight loss over the past year. Initial laboratory examination showed elevated blood glucose level (468 mg/dL [25.9 mmol/L]; normal reference range [RR], 75-109 mg/dL [4.

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