Choosing Wisely:

Don’t use plasma catecholamines to evaluate a patient for pheochromocytoma or paraganglioma. Instead, use plasma free metanephrines or urinary fractionated metanephrines.

Rationale and Comments: Recommended first-line testing is either plasma free metanephrines or urinary fractionated metanephrines. If measuring plasma metanephrines, patients should have their blood drawn while in a supine position, and the values should be compared to reference intervals determined from the same collection position.
Sponsoring Organizations:
  • American Society for Clinical Pathology
  • Sources:
  • Endocrine Society guidelines
  • Disciplines:
  • Cardiovascular
  • Endocrinologic
  • References: • Lenders JW, Duh QY, Eisenhofer G, Gimenez-Roqueplo AP, Grebe SK, Murad MH, Naruse M, Pacak K, Young WF Jr. Pheochromocytoma and paraganglioma: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2014 Jun;99(6):1915-1942.

    Email Alerts

    Don't miss a single issue. Sign up for the free AFP email table of contents.

    Sign Up Now