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Plasma or Urinary Metanephrines for the Diagnosis of Pheochromocytoma? That Is the Question

Emmanuel L. Bravo, MD
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Cleveland Clinic Foundation, Cleveland, OH 44195 Requests for Reprints: Emmanuel L. Bravo, MD, Department of Nephrology and Hypertension, Cleveland Clinic Foundation, 9500 Euclid Avenue, Mail Code A101, Cleveland, OH 44195.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1996;125(4):331-332. doi:10.7326/0003-4819-125-4-199608150-00012
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Several clinical disorders mimic the signs and symptoms of pheochromocytoma; the definitive diagnosis of this condition thus rests primarily on showing excessive and inappropriate production of catecholamine. Because pheochromocytoma is fatal if undiagnosed, biochemical tests used to detect it should have a high sensitivity. In addition, the predictive value of any negative test result should exclude false-negative results as efficiently as possible. A false-positive result is relatively less important because additional testing (using, for example, clonidine suppression, glucagon stimulation, and imaging techniques) can be done to rule out the disease.

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