Does my random urine test suggest pheochromocytoma?

Question

Hello doctor,

I had a random urine test for pheochromocytoma and I think my PCP is reading wrong. I went to the laboratory and gave an ambiguous report confusing people. She did say fourfold elevation normetanephrine and four-fold elevation u-metanephrine. I do have episodic severe hypertension attacks, palor, sweating, BP up to 256/131 mm of Hg for 20 minutes or so. Only very occasionally I have these attacks. As a 50 year old I never had sustained high blood pressure but now I do and am on large doses of medicines.

Do I have elevated lab work and what do you think it means?
U-metanephrine total QST 196 range 149 to 603. U-normetanephrine QST 148 range 108 to 524. U-epinephrine QST was below reportable range. Rest of numbers seem normal. What is your opinion?

Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your results showed raised urinary metanephrines but the other metabolites were within normal range. This could still indicate pheochromocytoma. I must say that your symptoms are quite suggestive of pheochromocytoma although not exclusively in favor of it.

I need to know if you also get panic attacks and whether you have any other disorders associated with your thyroid or parathyroid glands, as that would pretty much go in favor of this diagnosis. Metanephrines Let me know so that I can advise some tests which would confirm the diagnosis so that adequate treatment can be initiated.

I hope it helps.

Thank you and take care. Regards.

Answer 2

Hello,

Welcome back to icliniq.com.

It is likely that you have adrenal tumors most likely bilateral, which would explain the flank pain. Pheochromocytoma is usually benign and surgical removal of the tumor or tumors solves the problem. I would recommend you get a CT (computed tomography) scan of the whole abdomen done, which would prove the diagnosis and even locate the site in case of an extra-adrenal tumor.

Thank you and take care.