This test measures the amount of metanephrines in your urine that your body makes over a 24-hour period.
Metanephrines are made when your body breaks down hormones called catecholamines. These hormones are made by the adrenal glands. Catecholamines help your body respond to stress. They are sometimes called "fight or flight" hormones. They also include epinephrine, norepinephrine, and dopamine.
This test may have been ordered for you if your healthcare provider believes you have a condition called pheochromocytoma or paraganglioma. These are rare tumors that make extra amounts of catecholamines. Pheochromocytomas are found in the adrenal glands. Paragangliomas are found outside the adrenal glands.
Symptoms of pheochromocytoma or paraganglioma include:
High blood pressure
Paleness
Headaches
Sweating
Heart palpitations
Tremors
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If your 24-hour metanephrine level is twice the normal level or higher, it's likely that you have a pheochromocytoma or paraganglioma. You may need to have imaging tests, including CT or MRI scans. These tests are done to confirm the diagnosis and find the tumor.
The low prevalence of PPGL combined with the limited diagnostic specificity of the metanephrine test means that false-positive results far outnumber true-positive results. As outlined in the Endocrine Society Guidelines, all patients with positive test results should receive appropriate follow-up according to the extent of increased values and clinical presentation of the patient. The nature of this follow-up is a matter of clinical judgment based on the pretest probability of tumor and the extent and pattern of increases in test results.
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