Newcastle Laboratories

Metanephrines, urine

Clinical Background:

Phaeochromocytoma and functional paraganglioma are rare neuroendocrine tumours that are characterised by excessive secretion of catecholamines, occurring in approximately 0.1% of hypertensive patie...

Phaeochromocytoma and functional paraganglioma are rare neuroendocrine tumours that are characterised by excessive secretion of catecholamines, occurring in approximately 0.1% of hypertensive patients. The biochemical detection of this tumour involves confirmation of excess urinary excretion of metadrenalines. Urinary fractionated metadrenalines have been shown to be a more reliable biochemical index of increased tumour production of catecholamines than urinary catecholamines.

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Test Documents

Test Details

  • Discipline:

    Biochemistry

    Biochemistry

  • Specimen Container Adult:

    Overnight urine (sand/sulphuric acid preservative)

    Overnight urine (sand/sulphuric acid preservative)

  • Specimen Container Paediatric:

    Random urine sent to lab immediately

    Random urine sent to lab immediately

  • Minimum Volume Adult:

    1 - 10 mL urine

    1 - 10 mL urine

  • Minimum Volume Paediatric:

    1 - 10 mL urine

    1 - 10 mL urine

  • Special Requirement:

    Random samples have limited stability, send to lab immediately.

    Urine metanephrines are used for the diagnosis of phaeochromocytoma. To test for neuroblastoma - measure urine HMMA and HVA (neurobla...

    Random samples have limited stability, send to lab immediately.

    Urine metanephrines are used for the diagnosis of phaeochromocytoma. To test for neuroblastoma - measure urine HMMA and HVA (neuroblastoma screen).

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  • Sample Stability:

    Urine samples are stable at 4°C for up to 6 weeks. For longer periods store at –15°C.

    Urine samples are stable at 4°C for up to 6 weeks. For longer periods store at –15°C.

  • Transport Requirements:

    Ambient temperature

    Ambient temperature

  • Quality Assurance:

    UK National External Quality Assurance Scheme (NEQAS) for Urinary Catecholamines

    UK National External Quality Assurance Scheme (NEQAS) for Urinary Catecholamines

  • Interpretation:

    Urine metanephrine or normetanephrine values greater than 4 times the upper reference interval are highly suggestive of the presence of phaeochromocytoma/paraganglioma. Elevated results are reporte...

    Urine metanephrine or normetanephrine values greater than 4 times the upper reference interval are highly suggestive of the presence of phaeochromocytoma/paraganglioma. Elevated results are reported with appropriate comments.

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  • Reference Ranges:

    24-hour Metanephrine (µmol/24hr):

    0 - 9m: 0 – 0.2
    9 - 12m: 0 – 0.5
    1 - 2y: 0 – 0.3
    2 - 6y: 0.1 – 0.5
    6-10y: 0.3 – 0.7 

    10-16y: 0.2 – 1.2

    Adult (female): 0 – 1.8

    Adult (male): 0 - 2.2

     

    24-hour ...

    24-hour Metanephrine (µmol/24hr):

    0 - 9m: 0 – 0.2
    9 - 12m: 0 – 0.5
    1 - 2y: 0 – 0.3
    2 - 6y: 0.1 – 0.5
    6-10y: 0.3 – 0.7 

    10-16y: 0.2 – 1.2

    Adult (female): 0 – 1.8

    Adult (male): 0 - 2.2

     

    24-hour Normetanephrine (µmol/24hr):

    0 - 9m: 0.2 – 0.8
    9 - 12m: 0.1 – 0.6
    1 - 2y: 0.2 – 0.6
    2 - 6y: 0.3 – 0.6
    6-10y: 0.3 – 1.0 

    10-16y: 0.3 – 1.6

    Adult (female): 0 - 3.0

    Adult (male): 0 – 3.8

     

    24-hour 3-methoxytyramine (µmol/24hr):

    0 - 9m: N/A
    9 - 12m: N/A
    1 - 2y: N/A 
    2 - 6y: N/A 
    6-10y: N/A 

    10-16y: N/A

    Adult (female): 0 - 2.8

    Adult (male): 0 - 2.8

     

    Overnight / Random Metanephrine (­µmol/mmol creatinine):
    0 - 9m: 0.12 - 0.41
    9 - 12m: 0.08 - 0.37
    1 - 2y: 0.02 - 0.30
    2 - 6y: 0.04 - 0.29
    6-10y: 0.07 - 0.18 

    10-16y: 0 – 0.18

    Adult (female): 0 – 0.3

    Adult (male): 0 – 0.3

     

    Overnight / Random Normetanephrine (µmol/mmol creatinine):
    0 - 9m: 0.94 - 2.07
    9 - 12m: 0.16 - 0.68
    1 - 2y: 0.22 - 0.79
    2 - 6y: 0.06 - 0.37
    6 - 10y: 0.06 - 0.28
    10 - 16y: 0 - 0.25
    Adult (female): 0 - 0.35 

    Adult (male): 0 - 0.35 


    Overnight / Random 3-methoxytyramine (µmol/mmol creatinine):

    0 - 9m: N/A
    9 - 12m: N/A
    1 - 2y: N/A 
    2 - 6y: N/A 
    6-10y: N/A 

    10-16y: N/A

    Adult (female): 0 - 0.22

    Adult (male): 0 - 0.22


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  • Factors Affecting Result:

    Drugs can interfere analytically or pharmacodynamically with measurement of plasma or urinary metanephrines, potentially causing false positive results. Analytical interference is more likely to af...

    Drugs can interfere analytically or pharmacodynamically with measurement of plasma or urinary metanephrines, potentially causing false positive results. Analytical interference is more likely to affect the urine metanephrine HPLC-ECD assay. The LC-MS/MS method for plasma free metanephrines is considered to be far less susceptible to analytical interference.

    Many drugs are now known to increase catecholamine and metabolite concentrations, including tricyclic antideppressant's, selective serotonin reuptake inhibitors, serotonin and noradrenaline reuptake inhibitors, α- and β- adrenergic receptor blockers, calcium channel blockers, monoamine oxidase inhibitors, Levo(L)-Dopa, methyldopa and several stimulant/sympathomimetic drugs.

    Ideally patients should discontinue all medications that may affect plasma and urinary catecholamine or metanephrine concentrations prior to sampling. In practice, it is not always possible to discontinue medication before testing and it might be better to repeat testing only when initial tests are elevated.

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  • Routine Contact Name:

    Duty Biochemist

  • Routine Telephone:

    Freeman: 0191 244 8889
    RVI: 0191 282 9719

    Freeman: 0191 244 8889
    RVI: 0191 282 9719

  • Routine Email:

  • Specialist Test:

    Yes

    Yes

Availability:

Available during full access hours
Assayed as service demands
Site of analysis: Freeman

Turn Around:

Within 2 weeks

Send To:

Department of Blood Sciences

Freeman Hospital
Freeman Road
Newcastle upon Tyne
NE7 7DN

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