Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis (794 page)

BOOK: Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis
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   Hypoglycemia
   Hypotension
   Hypothyroidism
   DKA
   Neuroblastoma
   Paragangliomas
   Pheochromocytoma

Decreased In

   Norepinephrine: anorexia nervosa
   Autonomous nervous system dysfunction
   Orthostatic hypotension
   Dopamine: possibly decreased in Parkinson disease
   Limitations
   Most assays measure only free catecholamines, but a few measure both free and conjugated types. Free amines are more closely associated with tumor load than conjugated ones.
   Physiologic stimuli, drugs, or improper specimen collection slightly increases the levels. Patients should not eat, use tobacco, or drink caffeinated beverages for at least 4 hours before collection. Measurement of plasma or urine fractionated metanephrines provides better diagnostic sensitivity than measurement of catecholamines.

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