Screening for phaeochromocytoma in patients with acute cerebrovascular disease: Is it necessary?
- Author:
Nadiah Mohamed Zainuddin
1
Author Information
1. Department of Pathology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur
- Collective Name:Pavai Sthaneshwar; Jeyakantha Ratnasingam
- Publication Type:Journal Article
- Keywords:
phaeochromocytoma;
acute cerebrovascular disease;
catecholamines;
metanephrines;
screening
- From:The Malaysian Journal of Pathology
2020;42(2):203-207
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: Phaeochromocytoma may present with uncontrolled hypertension leading to haemorrhagic
stroke (HS), ischaemic stroke (IS) and transient ischaemic attack (TIA). False elevation in the levels
of CATS/ METS has been reported in acute cerebrovascular disease. Our aim was to analyse the
frequency and pattern of elevations of CATS/METS in patients with acute cerebrovascular disease
and to determine associated factors. Materials and Methods: This is a retrospective study of 112
samples of CATS/ METS received by the laboratory over a two-year period, from patients with acute
cerebrovascular disease. CATS/METS were measured using LC/MS/MS method. Clinical details and
CATS/METS level were obtained from the database. Mann-Whitney U test and Kruskal Wallis test
were used for statistical analysis. These statistical analyses were performed using SPSS v.20.0 (IBM
Corp., Armonk, NY, USA). Results: Of the 112 patients, 39% had HS, 54% had IS and 7% had TIA.
A total of 29% of patients had elevated CATS/ METS. Elevated levels of CATS/METS were noted
in 41% and 25% of HS and IS patients, respectively (p=0.53). Median norepinephrine, epinephrine
and metanephrine levels in HS were significantly higher than IS (p< 0.05). Systolic blood pressure
was higher in those who had elevated CATS/ METS (p=0.04). Only for two patients with elevated
CATS/METS repeat testing was performed. Age, diastolic blood pressure and the time of sample
collection in relation to the presentation, for CATS/METS were not significantly different between
groups that had elevated levels of CATS/ METS versus those who did not. Conclusion: We noted
that CATS/METS were elevated in one-third of patients, especially in patients with high systolic
blood pressure. Increase in CATS/METS should be appropriately followed up with repeat testing.
Since false elevation in CATS/METS has been reported in cerebrovascular disease, screening for
phaeochromocytoma is best deferred for a month.
- Full text:5.2020my010621.pdf
