Shawar L, Svec F
Dept of Medicine, LSU Medical Center, New Orleans 70112, USA.
J La State Med Soc. 1996 Dec;148(12):535-8.
Pheochromocytoma is usually diagnosed by finding elevated levels of metanephrines, catecholamines, or vanillylmandelic acid in 24-hour urine collections. At least two of the three urine analytes are usually elevated. We found no report of a documented pheochromocytoma in which only one of the three analytes was elevated. Herein we report a patient with severe hypertension and a right adrenal mass, who was found on repeated testing to have only elevated urinary metanephrines. The 24-hour urine collections for vanillylmandelic acid, total catecholamines, fractionated catecholamines, and urine dopamine were all normal. The patient underwent surgery for the right adrenal mass, and the pathology report confirmed the diagnosis of pheochromocytoma.
嗜铬细胞瘤通常通过检测24小时尿液中去甲肾上腺素、儿茶酚胺或香草扁桃酸水平升高来诊断。这三种尿液分析物中通常至少有两种升高。我们未发现仅一种分析物升高而确诊嗜铬细胞瘤的报道。在此，我们报告一名患有严重高血压和右侧肾上腺肿块的患者，经反复检测发现仅尿去甲肾上腺素升高。香草扁桃酸、总儿茶酚胺、分馏儿茶酚胺和尿多巴胺的24小时尿液检测均正常。该患者接受了右侧肾上腺肿块手术，病理报告证实为嗜铬细胞瘤。
