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Clonidine suppression test

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    Clonidine suppression test


    This test is performed to evaluate for pheochromocytoma when plasma norepinephrine (NE) is 1000–2000 pg/ml and/or plasma normetanephrine (NM) elevation that is less than four times the upper limit of the normal reference range. The test is performed to distinguish patients with pheochromocytoma from those with elevated plasma norepinephrine and normetanephrine levels from other etiologies. buy doxycycline hyclate online Endocrinology Handbook Endocrine Unit Imperial College Healthcare NHS Trust Charing Cross, Hammersmith and St. In normal patients, should suppress plasma catecholamines to ≤50% baseline and to ≤2.96 nmol/l (500 pg/l). Mary’s Hospitals Updated: March 2010 To exclude the diagnosis of phaeochromocytoma in patients with hypertension and borderline changes in plasma catecholamines or urinary catecholamine metabolites. Phaeochromocytoma patients should not suppress (positive result). et al., New Engl J Med 1981; 305: 623-626 Grossman E. Frail patient with a history of hypotensive episodes or severe coronary or carotid disease. Order the clonidine from pharmacy (readily obtainable). This test is 97% sensitive for phaeochromocytoma, but only 67% specific, meaning that it is a reasonable rule-out test for phaeos but not diagnostic. et al., Hypertension 1991; 3-741 SGG 1/90; revised TT 5/08. Stop hypotensive treatment for at least 24 hours before the test if possible. Clonidine acts via the alpha pre-ganglionic receptors to reduce catecholamine secretion. Contact biochemistry laboratory before doing the test, enquire how they would like the samples taken and arrange for their delivery.

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    Clonidine Suppression Test. The high false-positive rate for plasma fractionated catecholamines and fractionated metanephrines triggered the development of a confirmatory test, the clonidine suppression test. 80 This test is intended to distinguish between pheochromocytoma and false-positive increases in plasma fractionated catecholamines and. buy zithromax at walmart Clonidine-suppression tests were carried out in 48 patients with and 49 patients without the tumor. Tricyclic antidepressants and phenoxybenzamine accounted. We assessed the sensitivity and specificity of glucagon stimulation and clonidine suppression tests in the diagnosis of pheochromocytoma in 113 hypertensive.

    Measurements of plasma normetanephrine and metanephrine provide a highly sensitive test for diagnosis of pheochromocytoma, but false-positive results remain a problem. We therefore assessed medication-associated false-positive results and use of supplementary tests, including plasma normetanephrine responses to clonidine, to distinguish true- from false-positive results. The study included 208 patients with pheochromocytoma and 648 patients in whom pheochromocytoma was excluded. Clonidine-suppression tests were carried out in 48 patients with and 49 patients without the tumor. Tricyclic antidepressants and phenoxybenzamine accounted for 41% of false-positive elevations of plasma normetanephrine and 44–45% those of plasma and urinary norepinephrine. High plasma normetanephrine to norepinephrine or metanephrine to epinephrine ratios were strongly predictive of pheochromocytoma. Lack of decrease and elevated plasma levels of norepinephrine or normetanephrine after clonidine also confirmed pheochromocytoma with high specificity. In a prospective study designed to differentiate pheochromocytoma from other forms of hypertension, urinary catecholamines were measured after sleep and clonidine administration in 12 patients with pheochromocytoma, 19 hypertensive patients in whom pheochromocytoma was suspected but later excluded, and 31 hypertensive patients in whom pheochromocytoma was never suspected. The test correctly identified all 12 patients in whom pheochromocytoma was present. Four of these had equivocal plasma levels of both norepinephrine and epinephrine, suggesting that overnight clonidine suppression may be of particular value when tumor secretion is intermittent or low. When pheochromocytoma was not present, urinary norepinephrine and epinephrine levels were suppressed below 60 and 20 nmol/mmol creatinine, respectively, after sleep and clonidine, the two in combination giving better suppression than sleep alone. Since urinary catecholamines can be determined relatively easily by high-pressure liquid chromatography with electrochemical detection, this test may be more widely applicable than suppression tests based on plasma measurements.

    Clonidine suppression test

    Evaluation of Endocrine Tests. C glucagon and clonidine test in. - NJM, Biochemical Diagnosis of Pheochromocytoma How to Distinguish.

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  3. The clonidine test will only be required if there is strong clinical suspicion and. Overnight clonidine suppression test in the diagnosis and exclusion of.

    • Clonidine Test for Phaeochromocytoma - Leeds Pathology
    • Glucagon and clonidine testing in the diagnosis of. - AHA Journals
    • Clonodine Suppression Test for Phaeochromocytoma / Blood.

    Mar 28, 2015. Indication This test is performed to evaluate for pheochromocytoma when plasma norepinephrine NE is 1000–2000 pg/ml and/or plasma. clomid for twins The clonidine suppression test for pheochromocytoma has a positive predictive value of 67% to 93% and a negative predictive value of 94% to 100% from published reports. Clonidine is generally safe when adequate precautions are taken to avoid hypotension. Medical Intelligence from The New England Journal of Medicine — Clonidine-Suppression Test — A Useful Aid in the Diagnosis of Pheochromocytoma

     
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