Validation of Vanillylmandelic Acid (VMA) with Plasma Metanephrine and Normetanephrine for Screening Adrenal Medullary Disorders
Objective: To validate urinary Vanillylmandelic acid (VMA) for screening adrenal medullary disorders, taking plasma-free Metanephrine as the gold standard. Study Design: Cross-sectional validation study. Place and Duration of Study: Department of Chemical Pathology and Endocrinology, Armed Fo...
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| Format: | Article |
| Language: | English |
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Army Medical College Rawalpindi
2023-02-01
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| Series: | Pakistan Armed Forces Medical Journal |
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| Online Access: | https://www.pafmj.org/index.php/PAFMJ/article/view/6849 |
| _version_ | 1797856301299007488 |
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| author | Usama Bin Khalid Zujaja Hina Haroon Muhammad Aamir Sana Ashraf Afshan Bibi Haroon Javaid |
| author_facet | Usama Bin Khalid Zujaja Hina Haroon Muhammad Aamir Sana Ashraf Afshan Bibi Haroon Javaid |
| author_sort | Usama Bin Khalid |
| collection | DOAJ |
| description |
Objective: To validate urinary Vanillylmandelic acid (VMA) for screening adrenal medullary disorders, taking plasma-free Metanephrine as the gold standard.
Study Design: Cross-sectional validation study.
Place and Duration of Study: Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology,Rawalpindi, in collaboration with Armed Forces Institute of Urology, Rawalpindi from Pakistan, Jan 2020 to Mar 2021.
Methodology: One hundred and thirty (130) symptomatic hypertensive patients with adrenal masses on ultrasound were selected Urine and blood samples were collected under specified conditions after taking necessary precautions and subsequently analyzed. Taking plasma Metanephrine as a reference, sensitivity, specificity and predictive values were calculated at predefined cut-off values.
Results: In a young population with a mean age of 28.55±5.54 years, headache, palpitations and sweating were the predominant symptoms having a frequency of 130(100%), 116(89.2%) and 111(85.4%), respectively. Twenty-four hours urinary Vanillylmandelic acid had lower sensitivity (66.3%) than a random urinary VMA/cr ratio (72.1%) but similar specificity(97.7%). On the other hand, plasma-free Normetanephrine had 100% sensitivity but lower specificity (93.2%). ROC curve was plotted, and AUC for 24 hours urinary VMA, urinary VMA/cr ratio and plasma-free Normetanephrine were 0.820, 0.849 and0.966, respectively.
Conclusion: Plasma-free Metanephrine could be used for screening pheochromocytoma and other adrenal medullary disorders like paraganglionoma. In addition, VMA/cr ratio can be used for biochemical confirmation of the disease owing to the high specificity found in our study.
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| first_indexed | 2024-04-09T20:38:14Z |
| format | Article |
| id | doaj.art-b686da2a9bfb46acbd3d06d42624af08 |
| institution | Directory Open Access Journal |
| issn | 0030-9648 2411-8842 |
| language | English |
| last_indexed | 2024-04-09T20:38:14Z |
| publishDate | 2023-02-01 |
| publisher | Army Medical College Rawalpindi |
| record_format | Article |
| series | Pakistan Armed Forces Medical Journal |
| spelling | doaj.art-b686da2a9bfb46acbd3d06d42624af082023-03-30T06:25:33ZengArmy Medical College RawalpindiPakistan Armed Forces Medical Journal0030-96482411-88422023-02-0173110.51253/pafmj.v73i1.6849Validation of Vanillylmandelic Acid (VMA) with Plasma Metanephrine and Normetanephrine for Screening Adrenal Medullary DisordersUsama Bin Khalid0Zujaja Hina Haroon1Muhammad Aamir2Sana Ashraf3Afshan Bibi4Haroon Javaid5Armed Forces Institute of Pathology/National University of Medical Science(NUMS) Rawalpindi PakistanArmed Forces Institute of Pathology/National University of Medical Science(NUMS) Rawalpindi PakistanArmed Forces Institute of Pathology/National University of Medical Science(NUMS) Rawalpindi PakistanArmed Forces Institute of Radiology and Imaging/ National University of Medical Science(NUMS) Rawalpindi PakistanArmed Forces Institute of Pathology/National University of Medical Science(NUMS) Rawalpindi PakistanHeavy Industries Taxila Education City Institute of Medical Sciences, Texila/National University of Medical Science (NUMS) Pakistan Objective: To validate urinary Vanillylmandelic acid (VMA) for screening adrenal medullary disorders, taking plasma-free Metanephrine as the gold standard. Study Design: Cross-sectional validation study. Place and Duration of Study: Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology,Rawalpindi, in collaboration with Armed Forces Institute of Urology, Rawalpindi from Pakistan, Jan 2020 to Mar 2021. Methodology: One hundred and thirty (130) symptomatic hypertensive patients with adrenal masses on ultrasound were selected Urine and blood samples were collected under specified conditions after taking necessary precautions and subsequently analyzed. Taking plasma Metanephrine as a reference, sensitivity, specificity and predictive values were calculated at predefined cut-off values. Results: In a young population with a mean age of 28.55±5.54 years, headache, palpitations and sweating were the predominant symptoms having a frequency of 130(100%), 116(89.2%) and 111(85.4%), respectively. Twenty-four hours urinary Vanillylmandelic acid had lower sensitivity (66.3%) than a random urinary VMA/cr ratio (72.1%) but similar specificity(97.7%). On the other hand, plasma-free Normetanephrine had 100% sensitivity but lower specificity (93.2%). ROC curve was plotted, and AUC for 24 hours urinary VMA, urinary VMA/cr ratio and plasma-free Normetanephrine were 0.820, 0.849 and0.966, respectively. Conclusion: Plasma-free Metanephrine could be used for screening pheochromocytoma and other adrenal medullary disorders like paraganglionoma. In addition, VMA/cr ratio can be used for biochemical confirmation of the disease owing to the high specificity found in our study. https://www.pafmj.org/index.php/PAFMJ/article/view/6849MetanephrineNormetanephrineheochromocytomaVanillylmandelic acid |
| spellingShingle | Usama Bin Khalid Zujaja Hina Haroon Muhammad Aamir Sana Ashraf Afshan Bibi Haroon Javaid Validation of Vanillylmandelic Acid (VMA) with Plasma Metanephrine and Normetanephrine for Screening Adrenal Medullary Disorders Pakistan Armed Forces Medical Journal Metanephrine Normetanephrine heochromocytoma Vanillylmandelic acid |
| title | Validation of Vanillylmandelic Acid (VMA) with Plasma Metanephrine and Normetanephrine for Screening Adrenal Medullary Disorders |
| title_full | Validation of Vanillylmandelic Acid (VMA) with Plasma Metanephrine and Normetanephrine for Screening Adrenal Medullary Disorders |
| title_fullStr | Validation of Vanillylmandelic Acid (VMA) with Plasma Metanephrine and Normetanephrine for Screening Adrenal Medullary Disorders |
| title_full_unstemmed | Validation of Vanillylmandelic Acid (VMA) with Plasma Metanephrine and Normetanephrine for Screening Adrenal Medullary Disorders |
| title_short | Validation of Vanillylmandelic Acid (VMA) with Plasma Metanephrine and Normetanephrine for Screening Adrenal Medullary Disorders |
| title_sort | validation of vanillylmandelic acid vma with plasma metanephrine and normetanephrine for screening adrenal medullary disorders |
| topic | Metanephrine Normetanephrine heochromocytoma Vanillylmandelic acid |
| url | https://www.pafmj.org/index.php/PAFMJ/article/view/6849 |
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