Catecholamine and metanephrine excess in intracerebral haemorrhage: revisiting an obscure yet common “pseudophaeochromocytoma”
- 1Division of Medicine, Department of Endocrinology, Tan Tock Seng Hospital, Singapore, Singapore
- 2Division of Surgery, Department of Anaesthesia, Tan Tock Seng Hospital, Singapore, Singapore
- 3Division of Surgery, Department of Neurosurgery, National Neuroscience Institute, Singapore, Singapore
- Correspondence to: Dr M K S Leow Division of Medicine, Department of Endocrinology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore; mleowsj{at}massmed.org
We prospectively recruited five patients with CT evidence of intracerebral haemorrhage (ICH), having excluded trauma, a history of phaeochromocytoma (PHEO) and sympathomimetics/antihypertensives capable of increasing catecholamines (CATS)/metanephrines (METS). Informed consent was obtained from the next of kin. Plasma METS are superior to plasma CATS, although both are unavailable locally. Urinary CATS/METS, which integrate CATS/METS secretion and has greater sensitivity than plasma CATS in the absence of PHEO spells, was used.1 24 h urinary CATS/METS were sampled on days 1 and 7 and before discharge. Catheterised urine was transferred into bottles containing 10 ml 6 N HCl, and analysed by high-performance liquid chromatography (HPLC)–electrochemical detection. Patients with increases in CATS/METS underwent abdominal CT. ICH volume was estimated from CT. This research was ethically approved …
