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What do the reading mean in urine catecholomine test of child ?

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Practicing since : 1994
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My 6yr old son did 24hr urine catecholomine test as I have had phaechromocytoma removed. Results for dopamine, noradrenaline and ratio to creatinine have come back high. Possibility tests are against adults ratios but dr is not able to confirm.
Results are noradrenalin 437 nmol, noradrenaline/creatinine 93.0 nmol/nmol. adrenaline 39 nmol, adrenaline/creatinine 8.3 nmol/nmol.
dopamine 2673 nmol, dopamine/creatinine nmol/nmol.
urine creatinine4.4 nmol/L.
He uses a clenil 100mg inhaler - dont know if this would affect readings?
He is 24kgs and 4ft 2inches tall.
Posted Mon, 30 Apr 2012 in X-ray, Lab tests and Scans
Answered by Dr. P.V Pradeep 19 hours later

Thanks for the query. I need some info along with it.

I understand that you had surgery for pheochromocytoma at the age of 25yrs. Was it both sides or single side? The other question is that whether anybody in the your family had pheochromocytoma or any other endocrine cancers like medullary thyroid cancer or sudden unexplauined deaths in the family?

Coming on to your son's problem, we have to find out whether he is suffering from familial endocrinopathy.

For this following tests are needed next. Nothing is specific with the tests that were already done. Hence I recommend these. You can get it after checking with your doctor.

1) 24 hr urinary metanephrines/ 24 hr urinary fractionated metaphrines. If this is positive then a CECT of the abdomen and also MIBG scan to rule out multiple pheochromocytomas especially extra adrenal. If these are positive we also have to do genetic testing.
2) Your kid also needs to undergo Serum calcitonin and Serum Calcium tests if the first test is positive.

The current medication they are taking does not interfere with the metanephrine tests.

Let me know if you have got these done while we get the exact picture of the problem.

Warm regards
Above answer was peer-reviewed by
Follow-up: What do the reading mean in urine catecholomine test of child ? 54 minutes later
My phaeochromocytoma was just on right adrenal gland and full body scan was carried out to ensure there were no others. There are no other persons in my family who have had this condition or anything similar except for my mother who had a thyroid cyst which was benign.
My son had been showing some symptoms of phaeochromocytoma and as a precaution did catecholomines test approx 18 months ago as dr thought it very unlikely. The tests last year also came back high but consultant here said it was due to his age. He did have an ultra sound scan as a precaution and to put my mind at rest - the scan was clear. We are now seeing another dr who wasnt aware of there being different scales depending on age. This is the whole crux of my question to see if there are different result scales.
I will ask for these additional tests mentioned as although he is only 6 I have questioned his hormones as he can often smell of body odour in hot weather even though he is bathed and has clean clothes every day.
I really need to know if his results are high due to age or within the scale for children and the fact that the tests were analysed at a normal hospital as opposed to a childrens hospital. His result last yr for dopamine/creatanine ratio was 518 which we were told was ok with his age - it is now 569 and being told it is high?
Answered by Dr. P.V Pradeep 20 hours later
Hi again,

This child has normal values of catecholamines at present. yes there are different scales depending on the age and the information is not present everywhere. I did my part of search to say that the labs are normal.

I see that you are in UK. I suggest that next time if they are performing tests for pheochromocytoma please do not perform these tests. They are not helpful.

Currently recommended tests are
1) 24 hr urinary fractionnated metanephrines
2) Plasma Free metanephrines

All these tests have lot of lab to lab variations in the values and hence these labs will provide their cut off values too

Body odor has nothing to do with this suspected pheochromocytoma.

Warm regards.
Above answer was peer-reviewed by
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