DOCSLIB.ORG

One Platform for Determination of Urinary and Plasma Metabolites Relevant for Diagnostic Assessement of Neuroendocrine Tumors This Poster Is 48” Wide By

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
One Platform for Determination of Urinary and Plasma Metabolites Relevant for Diagnostic Assessement of Neuroendocrine Tumors This Poster Is 48” Wide By Printing: One platform for determination of urinary and plasma metabolites This poster is 48” wide by relevant for diagnostic assessement of neuroendocrine tumors 36” high. It’s designed to be Rajska M. | Prochazkova P. | Bartonikova D. | Loucka P | Minar J. | Radina M. | Garcic L. printed on a large-format printer. Polok Rajska M. | Loucka P. | Minar J. | Barvikova M. SPADIA Lab, a.s. Customizing the Dr. Slabihoudka Ostrava Poruba, Czech Republic [email protected] Content: The placeholders in this Introduction Metabolic pathway COMT poster are formatted for Neuroendocrine tumors (NETs), represent diverse group of disorders, which exhibit secretion of many hormonally Dopamine 3-MT active substances and thus cause various endocrine syndroms. Diagnostic alghorithm is based on the clinical you. Type in the MAO MAO symptomathology, morphological methods, laboratory diagnostics and RTG methods. For the detection of NETs in COMT Dihydroxyphenylacetic DBH HVA early stage the estimation of hormonally active substances and their metabolites is very important. acid placeholders to add text, or The analysis of catecholamine metabolites, both in plasma and in 24 hour urine collection, is of importance for the diagnosis of tumors of the sympathoadrenal system, such as pheochromocytomas or paragangliomas. In case of COMT click an icon to add a table, carcinoid tumors the diagnostic assessment is based on determination of 5-hydroxy-indolacetic acid in 24 hour urine Noradrenaline NMN collection and supported by additional determination of serotonin in serum. MAO MAO chart, SmartArt graphic, COMT Dihydroxymandelic PNMT VMA The aim of this work was to develop methods in such a way as to maintain the same configuration acid picture or multimedia file. MAO of the LC-MS/MS system (INSTRUMENT, ANALYTICAL COLUMNS, MOBILE PHASES). Methods for wider group of MAO COMT analytes relevant for diagnostic asessement of NETs were developed as follows: Adrenaline MN To add or remove bullet I. Metanphrine (MN) and Normetanephrine (NMN) in plasma II. Metanphrine (MN) and Normetanephrine (NMN) in 24 hour urine collection points from text, click the III. Serotonine (SER) in serum MAO, Ald-DH IV. Vanilmandelic (VMA), homovanillic (HVA) and 5-hydroxyindolacetic acid (5-HIAA) in 24 hour urine collection Serotonin 5-HIAA Bullets button on the Home LC-MS/MS method based on HILIC chromatography and ESI ionization Mass spectrometry conditions tab. Instrumentation: Materials used for determination of methods parameters: I. II. III. IV. If you need more Ionization Positive positive positive negative ºC • Agilent 6490 Triple Quadrupole • Purchased from Sigma-Aldrich: Gas temperature 135 135 135 135 ºC placeholders for titles, LC/MS System - Standards: MN, NMN, HVA, VMA, 5-HIAA, SER Gas flow 12 12 12 12 l/min ® ® • SeQuant ZIC HILIC HPLC 3.5mm, 100Å, - Deuterated IS: MN-d3, NMN-d3, HVA-d5, VMA-d3, 5-HIAA-d5 Nebulizer 45 45 45 45 Psi content or body text, make a 100 x 2.1 mm PEEK coated HPLC column • Purchased from Recipe: SGT 400 400 400 400 ºC SGF 10 10 10 10 l/min copy of what you need and Chromatographic separation - ClinCal®Serum Calibrator Set for Metanephrines Capillary 4000 4000 4000 3000 V • Binary pump: Gradient elution - ClinCheck®Serum Control for Metanephrines Nozzle voltage 0 0 0 1500 V drag it into place. MPA: 50mM NH COOH in H O - ClinCheck®Urine Control for Biogenic Amines 4 2 PowerPoint’s Smart Guides MPB: ACN - IS for serotonine (5-Hydroxy-N-methyltryptamine) Mass transition conditions ◦ • Purchased from Chromsystems • Column oven: 45 C Dwell Frag CAV will help you align it with Analyte Prec Prod CE [V] - Plasma Control Endocrine Hormones/Metabolites [ms] [V] [V] t [min] %A %B 0.0 20 80 • Patient samples – plasma (K3EDTA); 24h urine collection-acidified MN 180 148 70 380 11 4 everything else. 0.5 20 80 MN* 180 165 70 380 11 4 1.5 40 60 Sample preparation: MN-d3 183 151 70 380 11 4 Want to use your own 2.8 40 60 MN-d3* 183 168 70 380 11 4 2.9 20 80 Metanephrines in plasma 6.0 20 80 NMN 166 134 70 380 14 4 pictures instead of ours? No • 200ml of sample (calibrator, control, plasma) mix shortly with 50ml of IS (5mg/l of MN-d3 and NMN-d3 in ACN) NMN* 166 106 70 380 18 4 NMN-d3 169 137 70 380 10 4 problem! Just click a picture, Fig.1. Chromatogram for metanephrines in plasma • Precipitate with 1ml of isopropanol - mix vigorously for 30sec and centrifugate – 13000g/10min NMN-d3* 169 109 70 380 18 4 t [min] %A %B press the Delete key, then 0.0 20 80 • Transfer 1ml of supernatant to a glass tube and evaporate under SER 177 160 100 380 10 4 1.0 20 50 a slight stream of nitrogen; Reconstitution in 100ml of 80% ACN SER* 177 115 100 380 20 4 click the icon to add your 2.0 50 50 Serotonine in serum SER-IS 192 160 100 380 15 4 2.1 20 80 picture. 4.0 20 80 • 20ml of sample (calibrator, control, serum) mix for 30 sec with 180ml SER-IS* 192 115 100 380 25 4 of precipitant (80% ACN with IS for serotonine) and centrifuge – 10000g/5min HVA 181 137 75 380 4 4 HVA* 181 122 75 380 16 4 Metanephrines in urine HVA-d5 186 142 75 380 4 4 Fig.2. Chromatogram for serotonine in serum • 40ml of sample (calibrator, control, urine) mix shortly with 15ml of IS HVA-d5* 186 172 75 380 16 4 t [min] %A %B (1mg/l of MN-d3 and NMN-d3 in ACN) VMA 197 138 75 380 10 4 0.0 20 80 • Adjust samples pH and hydrolyze for 30min at 95ºC 0.5 20 80 VMA* 197 137 75 380 24 4 1.5 40 60 • Transfer 40ml of hydrolyzed sample, add 360ml of 80% ACN and mix VMA-d3 200 141 75 380 10 4 3.0 40 60 shorty and centrifuge – 10000g/5min VMA-d3* 200 140 75 380 24 4 3.2 20 80 VMA, HVA, 5-HIAA in urine 15.0 20 80 5-HIAA 190 144 75 380 6 4 • 10ml of sample (calibrator, control, urine) mix shortly with 10ml of IS (10mg/l of HVA-d5, VMA-d3, 5-HIAA-d5 in ACN), 5-HIAA* 190 146 75 380 24 4 5-HIAA-d5 195 151 75 380 6 4 Fig.3. Chromatogram for HVA, VMA, 5-HIAA in urine • Add 80ml of 80% ACN, mix for 30 sec and centrifuge – 10000g/5min 5-HIAA-d5* 195 149 75 380 24 4 Analytical parameters Conclusions Parameter P_MN P_NMN U_MN U_NMN S_SER U_HVA U_VMA U_-5HIAA Simple and fast approaches Calib. Range 0.140 – 7.175 0.196 – 9.956 0.120 – 10.140 0.021 – 10.890 4.7 – 2362.7 0.9 – 274.0 0.8 – 252.3 0.8 – 261.0 • Methods are simple, fast and ensures grater throughput of nmol/l nmol/l mmol/l mmol/l nmol/l mmol/l mmol/l mmol/l samples than HPLC with ECD detection 0,057 0,103 0,020 0,021 4.7 0.9 0.8 2.9 • Sample prep. requires precipitation with isopropanol or ACN LLQ (CV=8.7%) (CV=9.6%) (CV=2.6%) (CV=1.5%) (CV=11.4%) (CV=10.5%) (CV=11.3%) (CV=6.5%) but there is no need for the step of derivatization Recovery (%) 95 – 99 89 – 98 95 – 101 85 – 92 86 – 90 80 – 89 92 – 101 94 – 105 Satisfactory analytical parameters Intra-assay MEAN±SD 0.118 ± 0.006 0.778 ± 0.019 0.887 ± 0.036 1.734 ± 0.102 552.3 ± 21.6 15.2 ± 0.8 26.2 ± 1.9 14.1 ± 1.2 • LLQ, Recoveries precition (CV=5.4%) 2.4 4.1 5.9 3.7 5.3 7.3 8.3 • Methods are reliable in terms of precision Inter-assay MEAN±SD 0.295 ± 0.012 0.630 ± 0.051 0.905 ± 0.034 1.657 ± 0.075 553.7 ± 57.3 27.3 ± 2.8 27.1 ± 2.6 23.0 ± 2.8 precision (CV=4.2%) 8.1 3.8 4.5 10.7 10.4 9.6 12.1 • The calibration curves provides linearity in the relevant ranges One system configuration for neuroendocrine tumor markers. Developed methods slightly differ in sample prep and gradient elution. They are suitable for routine practice in diagnostic lab .
Load more

Recommended publications
  • Pheochromocytoma: a Single-Center Retrospective Review
    Central Journal of Clinical Nephrology and Research Review Article *Corresponding author Jose Rueda, MD, Division of Nephrology and Hypertension, Oregon Health & Science University, Mail Code: SJH6, 3181 S.W. Sam Jackson Park Road, Pheochromocytoma: A Single- Portland, OR 97239-309, Tel: 5034943442; Email: [email protected] Submitted: 18 February, 2021 Center Retrospective Review Accepted: 22 February, 2021 Benjamin K Elstrott1*, Lubna Khan2*, Divine Ribakare1,2, Published: 24 February, 2021 ISSN: 2379-0652 Abdallah Alali1,2, Ali Olyaei1,2,4, James Y Lim1,3, Jose F Rueda1,2 Copyright 1 Oregon Health & Science University, Portland © 2021 Elstrott BK, et al. 2Division of Nephrology and Hypertension, Portland OPEN ACCESS 3Department of Surgery, Portland 4Oregon State University, College of Pharmacy Keywords • Pheochromocytoma Abstract • Adrenal Gland Neoplasms • Incidental Findings Background: The presentation of modern pheochromocytoma is changing alongside advances in • Adrenal medulla medical practice. This retrospective review depicts the clinical presentation and biochemical properties of • Adrenalectomy pheochromocytomas as a function of size and cause for workup. Materials and Methods: Single-center retrospective chart review of imaging studies, biochemical testing results, and provider documentation written prior to surgical resections performed for pheochromocytoma between 1998 and 2018. Results: Forty-four patients were found to have 49 pheochromocytomas on pathology. The most common presentation was through incidental imaging findings of an adrenal mass (38.6%), followed by symptoms (34.1%), and then screening for known genetic risk (27.3%). Median unenhanced CT attenuation was 36 HU (range 17-85). Median pheochromocytoma size on imaging was 3.4 cm (range 1.0-12.2 cm). Median mass size in symptoms, incidental mass, and genetic risk groups were 4.1 cm, 3.4 cm, and 2.3 cm respectively (p = 0.090).
    [Show full text]
  • Simultaneous Quantification of Plasma 3-Methoxytyramine, Metanephrine and Normetanephrine by Ultraperformance LC-MSMS
    P23a Simultaneous Quantification of Plasma 3-Methoxytyramine, Metanephrine and Normetanephrine by Ultraperformance LC-MSMS Erdim Sertoglu (1), Namik Kemal Nazaroglu (2) (1) University of Health Sciences, Gulhane School of Medicine, Department of Medical Biochemistry, Ankara, Turkey (2) Synlab Ankara Laboratory, Ankara, Turkey SHORT ABSTRACT Methods and LC-MS/MS Conditions Metanephrine (MN), normetanephrine (NMN), and 3-methoxytyramine (MTY) are are produced Reversed-phase HPLC separation was performed using a Raptor HILIC-Si LC column (50 x 2.1 mm by O-methylation of the catecholamines. In this study, we aimed to develop a rapid and sensitive (i.d.); 2.7 μm particle size) after extraction onto Oasis WCX (1 mL, 10 mg) 30 µm cartridges. mass spectrometry based method coupled to ultraperformance liquid chromatography (UPLC- Samples were injected at a flow of 0.6 mL/min using a gradient of mobile phases A (95:5 Water:ACN MS/MS) to measure these plasma catecholamine metabolites for the diagnosis of + 30 mM ammonium formate) and B (15:85 Water:ACN + 30 mM ammonium formate). Details of neuroendocrine tumors. Reversed-phase HPLC separation was performed using a Raptor analysis conditions are presented in Table 2. HILIC-Si LC column (50 x 2.1 mm (i.d.); 2.7 μm particle size) after extraction onto Oasis WCX (1 mL, 10 mg) 30 µm solid-phase extraction cartridges. This method, with good precision, RESUTS sensitivity and linearity, can be used in clinical and research laboratories. Precision experiments to determine intra-day and inter-day precisions were performed using two replicates of level 2 control material (levels were 378 ng/L, 244 ng/L and 196 ng/L for MN, NMN and INTRODUCTION MTY, respectively) across three independent analytical runs.
    [Show full text]
  • How Does the Ans Work?
    Principles of Autonomic Medicine Version 1.0 HOW DOES THE ANS WORK? -- 105 -- Principles of Autonomic Medicine Version 1.0 GETTING THE MESSAGE ACROSS Chemical Messengers of the ANS: An Introduction The autonomic nervous system works by releasing messenger chemicals inside the body. These chemicals act on receptors on target cells, such as heart muscle cells, and this changes body functions. The chemical messengers of the autonomic nervous system are the neurotransmitters, acetylcholine and norepinephrine, and the hormone, adrenaline. Acetylcholine is the chemical messenger of the parasympathetic nervous system (PNS), the sympathetic cholinergic system (SCS), and the somatic nervous system. Norepinephrine is the chemical messenger of the sympathetic noradrenergic system (SNS), and adrenaline is the chemical messenger of the sympathetic adrenergic system (SAS). The transmission of chemicals in the autonomic nervous system (neurotransmission) involves a few common steps, although there are some important variations on the theme. -- 106 -- Principles of Autonomic Medicine Version 1.0 Some common themes in how autonomic nerves work. First of all, acetylcholine, norepinephrine, and adrenaline are stored in tiny bubble-like structures called vesicles. In the cases of acetylcholine and adrenaline, the chemical messengers are produced in the cytoplasm (“cell juice”) and then are actively pumped into the vesicles. In the case of norepinephrine, the chemical messenger is produced within the vesicles. The neurotransmitter is released by exocytosis, where the vesicle moves to the cell membrane surface of the cell, a hole forms at the junction of the vesicle and cell membrane, and the messenger makes it way out of the cell. Microscopically, there is a little “omega sign.” -- 107 -- Principles of Autonomic Medicine Version 1.0 Exocytosis, the process of neurotransmitter release Third, the chemical messenger, sometimes called a “first messenger,” reaches specific receptors on the target cells.
    [Show full text]
  • Diagnostic Efficacy of Unconjugated Plasma Metanephrines for the Detection of Pheochromocytoma
    ORIGINAL INVESTIGATION Diagnostic Efficacy of Unconjugated Plasma Metanephrines for the Detection of Pheochromocytoma Wolfgang Raber, MD; Wolfgang Raffesberg; Martin Bischof, MD; Christian Scheuba, MD; Bruno Niederle, MD; Slobodan Gasic, MD; Werner Waldha¨usl, MD; Michael Roden, MD Background: Recently, measurement of plasma meta- months after surgery. Patients with pheochromocytoma nephrines was suggested to improve the detection of (n=17) and with histologically proved other adrenal pheochromocytoma compared with the other common tumors (n=14) were studied before, during, and after biochemical tests. surgery. Objective: To examine the diagnostic precision of mea- Results: Measurement of plasma metanephrines and surements of plasma metanephrines, plasma catechol- plasma and urinary catecholamines provided 100% and amines, and urinary catecholamines and to assess their 82% sensitivity, respectively, for the detection of pheo- variability. chromocytoma (P,.001). Levels of plasma catechol- amines but not metanephrines increased in response to Methods: Plasma metanephrine as well as plasma and change of posture (norepinephrine, P=.03; epineph- urinary catecholamine concentrations were measured rine, P=.07) and intraoperative stress (norepinephrine, by high-performance liquid chromatography with elec- P=.002; epinephrine, P=.009). trochemical detection. Before surgery, responses of plasma metanephrines and catecholamines to change of Conclusions: Plasma metanephrines offer improved posture were determined. Intraoperatively, metaneph- efficacy for the diagnosis of pheochromocytoma. Less vari- rines and catecholamines were measured before skin ability in response to external factors may favor plasma incision, during maximal mechanical tumor manipula- metanephrines in the screening for this disease. tion, and repetitively after the tumor was separated from the circulation. Patients were reexamined 1 and 3 Arch Intern Med.
    [Show full text]
  • Stabilization of Urinary Biogenic Amines Measured in Clinical Chemistry Laboratories
    Clinica Chimica Acta 514 (2021) 24–28 Contents lists available at ScienceDirect Clinica Chimica Acta journal homepage: www.elsevier.com/locate/cca Stabilization of urinary biogenic amines measured in clinical chemistry laboratories Philippe J. Eugster *, Catherine Centeno , Marielle Dunand , Caroline Seghezzi , Eric Grouzmann Laboratory of Catecholamines and Peptides, Service of Clinical Pharmacology, Lausanne University Hospital and University of Lausanne, Switzerland ARTICLE INFO ABSTRACT Keywords: Urinary 5-hydroxyindoleacetic acid (5-HIAA), vanillylmandelic (VMA), homovanillic acid (HVA), catechol­ 5-hydroxyindoleacetic acid amines and metanephrines are produced in excess by catecholamine-producing tumors. These biogenic amines Vanillylmandelic acid are unstable at low or high pH and require hydrochloric acid (HCl) to prevent their degradation. However, HCl Catecholamines addition may result in very low pH causing degradation or deconjugation of several metabolites. This study Metanephrines evaluated the buffering properties of sodium citrate to stabilize all biogenic amines. Stability Urine The metabolite concentrations were measured by LC-MS/MS or by a coulometric assay in 22 urine samples collected native and with HCl or sodium citrate. We studied the effect of pH, time (48 h, four weeks) and storage ◦ ◦ ◦ temperature at 22 C, 4 C, and 20 C. We found that catecholamines degradation was prevented by HCl and citrate and that 5-HIAA was degraded in 5 out of 22 samples collected with HCl. All biogenic amines were efficientlystabilized by citrate for four weeks at ◦ ◦ ◦ 22 C, except epinephrine (48 h at 4 C, or four weeks at 20 C). Sodium citrate did not cause quantificationor analytical artefacts concerns. In conclusion, sodium citrate is a non-hazardous alternative to HCl for patients to send unfrozen urine samples to the laboratory which may safely store the sample for four weeks.
    [Show full text]
  • The Economic Implications of Three Biochemical Screening Algorithms for Pheochromocytoma
    0021-972X/04/$15.00/0 The Journal of Clinical Endocrinology & Metabolism 89(6):2859–2866 Printed in U.S.A. Copyright © 2004 by The Endocrine Society doi: 10.1210/jc.2003-031127 The Economic Implications of Three Biochemical Screening Algorithms for Pheochromocytoma ANNA M. SAWKA, AMIRAM GAFNI, LEHANA THABANE, AND WILLIAM F. YOUNG, JR. Division of Endocrinology, Metabolism, Nutrition, and Internal Medicine (W.F.Y.), Mayo Clinic, Rochester, Minnesota 55905; Department of Internal Medicine and Division of Endocrinology (A.M.S.), St. Joseph’s Healthcare, Hamilton, Ontario, Canada L8N 4A6; Department of Internal Medicine and Division of Endocrinology (A.M.S.), McMaster University, Hamilton, Ontario, Canada L8N 3Z5; Centre for Evaluation of Medicines (L.T.), St. Joseph’s Healthcare, Hamilton, Downloaded from https://academic.oup.com/jcem/article/89/6/2859/2870332 by guest on 24 September 2021 Ontario, Canada L8N 1G6; and Department of Clinical Epidemiology and Biostatistics (L.T., A.G.), McMaster University, Hamilton, Ontario, Canada L8N 3Z5 Pheochromocytoma is a rare, life-threatening condition. Using offs would undergo 24-h urinary measurements (total meta- a modeling technique, we studied the economic implications of nephrines and fractionated catecholamines) and be imaged if detection strategies for pheochromocytoma (third-party payer positive. We determined that, if 100,000 hypertensive patients perspective). The diagnostic efficacy of biochemical tests was (including 500 patients with pheochromocytoma) were tested, based on Mayo Clinic Rochester data. In all hypothetical algo- algorithm A (measurement of fractionated plasma metaneph- rithms, positive biochemical tests were followed by abdominal rines alone) would detect 489 pheochromocytoma patients at computerized tomography and, if negative, metaiodobenzylgua- a cost of 56.6 million dollars, whereas B (24-h urinary mea- nidine scintigraphy.
    [Show full text]
  • Negative Urinary Fractionated Metanephrines and Elevated
    Metab y & o g lic lo S o y n n i r d Endocrinology & Metabolic c r o o m d n e E Carrillo et al., Endocrinol Metab Synd 2015, 4:1 ISSN: 2161-1017 Syndrome DOI: 10.4172/2161-1017.1000i004 Clinical Image Open Access Negative Urinary Fractionated Metanephrines and Elevated Urinary Vanillylmandelic Acid in a Patient with a Sympathetic Paravesical Paraganglioma Lisseth Fernanda Marín Carrillo1* and Edwin Antonio Wandurraga Sánchez2 1Centro Médico Carlos Ardila Lulle, Carrera 24 # 154-106, Urbanización El Bosque, Torre B Módulo 55 consultorio 806, Floridablanca, Santander, Colombia 2Deparment of Endocrinology and Molecular Oncology, Universidad Autónoma de Bucaramanga UNAB Campus El Bosque, Calle 157 # 14 – 55 Floridablanca, Santander, Colombia *Corresponding author: Lisseth Fernanda Marín Carrillo, Centro Médico Carlos Ardila Lulle, Carrera 24 # 154-106, Urbanización El Bosque. Torre B Módulo 55 consultorio 806, Floridablanca, Santander, Colombia, Tel: +57689303, +573188481025; E-mail: [email protected] Received date: Jan 06, 2015, Accepted date: Jan 07, 2015, Published date: Jan 9, 2015 Copyright: © 2015 Carrillo LFM, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Clinical Image hrs). An 18 fluorodeoxiglucose PET/CT study (18 FDG PET/CT) showed an abnormal glucose uptake in the bladder with 16.9 SUVs. No distant metastases were reported. Surgical resection was performed successfully and antihypertensive medication was discontinued. The patient remains asymptomatic and normotensive (unmedicated). Results of genetic testing are pending [1-3].
    [Show full text]
  • Timed-Urine-For-Catecholamines-Metanephrines-VMA-HVA-5-HIAA.Pdf
    Patient Instructions Timed Urine for Catecholamines, Metanephrines, VMA, HVA, and 5HIAA Testing If you are taking or unsure about any of the medications listed below, we suggest that you first consult with your doctor and ask if they can be safely discontinued for 1 week before the test. Catecholamines (Epinephrine, Norepinephrine, Dopamine) Metanephrines (Metanephrine and Normetanephrine), VMA and/or HVA: You will be required to follow these instructions for 72 hours prior to the test and during the collection of the 24 hour urine. Avoid the following: Tea, coffee, energy drinks, alcohol, tobacco Strenuous exercise L-dopa, MAO inhibitors, TCAs, nasal decongestants or antihistamines containing pseudoephedrine, non-selective alpha blockers and other medications likely to interfere with catecholamines and their metabolism Foods: Bananas Potatoes Fruit Juices Beans Nuts Hard Cheese Tomatoes After you have been on the diet restrictions for 3 days, you will collect urine in the bottle provided for a 24 hour period according to the “Timed Urine Collection Instructions”. Note: Common antihypertensives (diuretics, ACE inhibitors, calcium channel blockers, alpha / beta blockers) may be continued as these are expected to cause little or no interference. 5-HIAA Testing: You will be required to follow a special diet for 72 hours prior to the test and during the collection of the 24 hour urine. Avoid the following: Foods: Avocados Melons (all) Bananas Nuts (all) Dates Pineapple Eggplant Plums Grapefruit Tomatoes Kiwi fruit Title: Timed Urine for Catecholamines - Metanephrines - VMA - HVA and 5 HIAA Doc.#38104 Ver 1.1 Page 1 of 2 Medications and Supplements: Salicylates (e.g. Aspirin) Acetaminophen L-dopa Cough syrup containing guaifenesin Herbal remedies Supplements for serotonin, tryptophan or 5-HTP After you have been on the diet restrictions for 3 days, you will collect urine in the bottle provided for a 24 hour period according to the “Timed Urine Collection Instructions”.
    [Show full text]
  • Catecholamine Metabolism: a Contemporary View with Implications for Physiology and Medicine
    0031-6997/04/5603-331–349$7.00 PHARMACOLOGICAL REVIEWS Vol. 56, No. 3 U.S. Government work not protected by U.S. copyright 40301/1169402 Pharmacol Rev 56:331–349, 2004 Printed in U.S.A Catecholamine Metabolism: A Contemporary View with Implications for Physiology and Medicine GRAEME EISENHOFER, IRWIN J. KOPIN, AND DAVID S. GOLDSTEIN Clinical Neurocardiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland Abstract ................................................................................ 331 I. Introduction ............................................................................ 331 II. Facts and fallacies ....................................................................... 332 A. Catecholamine deamination ........................................................... 333 B. Formation of vanillylmandelic acid ..................................................... 334 C. Contribution of vesicular leakage to catecholamine metabolism ........................... 335 Downloaded from D. Neuronal and extraneuronal catecholamine metabolism .................................. 336 E. Central and peripheral contributions to norepinephrine metabolism ....................... 337 F. Central and peripheral contributions to dopamine metabolism ............................ 338 III. Clinical implications ..................................................................... 339 A. Neurodegenerative processes .......................................................... 339 B. Neurocirculatory
    [Show full text]
  • Plasma Free Metanephrines for Diagnosis of Neuroblastoma Patients
    Clinical Biochemistry 66 (2019) 57–62 Contents lists available at ScienceDirect Clinical Biochemistry journal homepage: www.elsevier.com/locate/clinbiochem Plasma free metanephrines for diagnosis of neuroblastoma patients T Sebastiano Barcoa,1, Iedan Verlyb,c,d,1, Maria Valeria Corriase, Stefania Sorrentinof, Massimo Contef, Gino Tripodia, Godelieve Tytgatb,c, André van Kuilenburgd, Maria van der Hamg, ⁎ Monique de Sain-van der Veldeng, Alberto Garaventaf, Giuliana Cangemia, a Central Laboratory of Analyses, IRCCS Istituto Giannina Gaslini, Genoa, Italy b Department of Pediatric Oncology, Amsterdam UMC, Amsterdam, the Netherlands c Princess Maxima Center for Pediatric Oncology, Utrecht, the Netherlands d Laboratory of Genetic Metabolic Disorders, Amsterdam UMC, Amsterdam, the Netherlands e Laboratory of experimental therapies in oncology, IRCCS Istituto Giannina Gaslini, Genoa, Italy f Department of Pediatric oncology, IRCCS Istituto Giannina Gaslini, Genoa, Italy g Department of Genetics, Section Metabolic Diagnostics, WKZ, Utrecht, the Netherlands ARTICLE INFO ABSTRACT Keywords: Introduction: A substantial number of patients with neuroblastoma (NB) have increased excretion of catecho- Plasma free metanephrines lamines and metanephrines. Here, we have investigated the diagnostic role of plasma free metanephrines (PFM), Neuroblastoma metanephrine (MN), normetanephrine (NMN) and 3-methoxytyramine (3MT) for NB, the most common extra- Liquid chromatography-tandem mass cranial solid tumour in children. spectrometry Methods: PFM were quantified by using a commercial IVD-CE LC-MS/MS method on a TSQ Quantiva coupled to Diagnosis an Ultimate 3000. The method was further validated on 103 samples from pediatric subjects (54 patients with histologically confirmed NB and 49 age and sex matched controls). Correlations between PFM concentrations with clinical factors were tested.
    [Show full text]
  • Principles-Of-Autonomic-Medicine-V
    Principles of Autonomic Medicine v. 2.1 DISCLAIMERS This work was produced as an Official Duty Activity while the author was an employee of the United States Government. The text and original figures in this book are in the public domain and may be distributed or copied freely. Use of appropriate byline or credit is requested. For reproduction of copyrighted material, permission by the copyright holder is required. The views and opinions expressed here are those of the author and do not necessarily state or reflect those of the United States Government or any of its components. References in this book to specific commercial products, processes, services by trade name, trademark, manufacturer, or otherwise do not necessarily constitute or imply their endorsement, recommendation, or favoring by the United States Government or its employees. The appearance of external hyperlinks is provided with the intent of meeting the mission of the National Institute of Neurological Disorders and Stroke. Such appearance does not constitute an endorsement by the United States Government or any of its employees of the linked web sites or of the information, products or services contained at those sites. Neither the United States Government nor any of its employees, including the author, exercise any editorial control over the information that may be found on these external sites. Permission was obtained from the following for reproduction of pictures in this book. Other reproduced pictures were from -- 1 -- Principles of Autonomic Medicine v. 2.1 Wikipedia Commons or had no copyright. Tootsie Roll Industries, LLC (Tootsie Roll Pop, p. 26) Dr. Paul Greengard (portrait photo, p.
    [Show full text]
  • Analysis of Catecholamines and Pterins in Inborn Errors of Monoamine Neurotransmitter Metabolism—From Past to Future
    cells Review Analysis of Catecholamines and Pterins in Inborn Errors of Monoamine Neurotransmitter Metabolism—From Past to Future Sabine Jung-Klawitter * and Oya Kuseyri Hübschmann Department of General Pediatrics, Division of Neuropediatrics and Metabolic Medicine, University Hospital Heidelberg, 69120 Heidelberg, Germany * Correspondence: [email protected]; Tel.: +49-(0)6221-5639586 Received: 30 June 2019; Accepted: 4 August 2019; Published: 9 August 2019 Abstract: Inborn errors of monoamine neurotransmitter biosynthesis and degradation belong to the rare inborn errors of metabolism. They are caused by monogenic variants in the genes encoding the proteins involved in (1) neurotransmitter biosynthesis (like tyrosine hydroxylase (TH) and aromatic amino acid decarboxylase (AADC)), (2) in tetrahydrobiopterin (BH4) cofactor biosynthesis (GTP cyclohydrolase 1 (GTPCH), 6-pyruvoyl-tetrahydropterin synthase (PTPS), sepiapterin reductase (SPR)) and recycling (pterin-4a-carbinolamine dehydratase (PCD), dihydropteridine reductase (DHPR)), or (3) in co-chaperones (DNAJC12). Clinically, they present early during childhood with a lack of monoamine neurotransmitters, especially dopamine and its products norepinephrine and epinephrine. Classical symptoms include autonomous dysregulations, hypotonia, movement disorders, and developmental delay. Therapy is predominantly based on supplementation of missing cofactors or neurotransmitter precursors. However, diagnosis is difficult and is predominantly based on quantitative detection of neurotransmitters, cofactors, and precursors in cerebrospinal fluid (CSF), urine, and blood. This review aims at summarizing the diverse analytical tools routinely used for diagnosis to determine quantitatively the amounts of neurotransmitters and cofactors in the different types of samples used to identify patients suffering from these rare diseases. Keywords: inborn errors of metabolism; catecholamines; pterins; HPLC; fluorescence detection; electrochemical detection; MS/MS 1.
    [Show full text]