Endocrinology MET

Metanephrines .

Quantitative determination of free plasma metanephrines for diagnosis of catecholamine-secreting tumours. Performed by LC-MS/MS.

Quick Reference
Method
LC-MS/MS
Sample Types
Plasma
Analytes

3 analytes

Turnaround

3–5 working days

Enquire About This Test

What does this test assess?

This method measures three O-methylated catecholamine metabolites in plasma for the biochemical diagnosis and exclusion of phaeochromocytoma and paraganglioma.

Clinical indications include:

  • Diagnosis and exclusion of phaeochromocytoma
  • Diagnosis of extra-adrenal paraganglioma
  • Screening of high-risk individuals (hereditary syndromes: MEN2, VHL, SDH mutations)
  • Investigation of resistant or paroxysmal hypertension
  • Evaluation of adrenal incidentaloma for catecholamine excess
  • Post-operative surveillance for tumour recurrence

Measured analytes

Analyte / GroupComponentsClinical Significance
Metanephrine MN O-methylated metabolite of adrenaline (epinephrine)
Normetanephrine NMN O-methylated metabolite of noradrenaline (norepinephrine)
3-Methoxytyramine 3-MT O-methylated metabolite of dopamine; marker of dopamine-secreting tumours
Note

Plasma free metanephrines have the highest sensitivity (96–100%) of any biochemical test for phaeochromocytoma, making them the recommended first-line test.

About metanephrines

Metanephrines are produced by the continuous intratumoral metabolism of catecholamines by catechol-O-methyltransferase (COMT). Unlike catecholamines themselves, which are released episodically, metanephrines are produced continuously by tumour tissue, providing a more reliable biochemical marker.

96–100%

Sensitivity for phaeochromocytoma detection

3 analytes

Covering adrenaline, noradrenaline, and dopamine pathways

First-line

Recommended first-line biochemical test by Endocrine Society

Phaeochromocytomas and paragangliomas (PPGLs) are rare catecholamine-secreting tumours with potentially life-threatening consequences including hypertensive crisis, stroke, and myocardial infarction. Early biochemical detection is critical, as surgical resection is curative in the majority of cases.

The inclusion of 3-methoxytyramine extends diagnostic coverage to dopamine-secreting tumours, which may present without the classic hypertensive symptoms and can be missed by tests measuring only metanephrine and normetanephrine.

Analytical technique

Plasma free metanephrines are measured by isotope-dilution LC-MS/MS following solid-phase extraction. This approach provides the specificity necessary to avoid false positives from interfering substances and medications, which is a significant limitation of immunoassay-based methods.

Sample information

Blood should be drawn after 20–30 minutes of supine rest to minimise sympathetic activation-related false elevations. Medications known to interfere (tricyclic antidepressants, MAO inhibitors) should be noted on the request form.

Testing process

From enquiry to results — a straightforward process.

1
Get in touch
Contact us to discuss your testing requirements
2
Collect your sample
Blood sample collected by a healthcare professional via standard venepuncture
3
Post to our lab
Samples shipped to our laboratory following standard pre-analytical protocols
4
Receive results
Results delivered within 3–5 working days of sample receipt

Where this test is available

This test is available to healthcare professionals, wellness brands, clinics, and research institutions worldwide. We currently serve partners in:

  • Europe (EU & non-EU)
  • United Kingdom
  • Asia & Southeast Asia
  • Australia & New Zealand
  • United States

Whether you need testing services for your patients, white-label kits for your brand, or method transfer to your own laboratory — get in touch to discuss how we can work together.

Literature

  1. Lenders JWM, et al. “Phaeochromocytoma and paraganglioma: an Endocrine Society clinical practice guideline.” Journal of Clinical Endocrinology & Metabolism, 2014, 99(6):1915-1942. 10.1210/jc.2014-1498
  2. Eisenhofer G, et al. “Plasma metanephrines are markers of pheochromocytoma produced by catechol-O-methyltransferase within tumors.” Journal of Clinical Endocrinology & Metabolism, 1998, 83(6):2175-2185. 10.1210/jcem.83.6.4870

Frequently Asked Questions

What are metanephrines?

Metanephrine, normetanephrine, and 3-methoxytyramine are metabolites of adrenaline, noradrenaline, and dopamine respectively. They are produced continuously by catecholamine-secreting tumours.

Why is this test used for phaeochromocytoma screening?

Unlike catecholamines (which are released in bursts), metanephrines are produced continuously by tumour tissue. Plasma free metanephrines by LC-MS/MS have the highest sensitivity (96–100%) for detecting phaeochromocytoma.

How is the sample collected?

Venous blood draw after 20–30 minutes of supine rest. Specific collection protocol to minimise false positives.

How long does it take to get results?

Results are typically delivered within 3 to 5 working days from the time your sample arrives at our laboratory. The analysis is performed by LC-MS/MS.

What can cause false positive metanephrine results?

Stress, exercise, certain medications (tricyclic antidepressants, MAO inhibitors, decongestants), caffeine, and incorrect sample collection. LC-MS/MS is more specific than immunoassay, reducing false positives.

Which countries is this test available in?

Masdiag's metanephrines test is available worldwide through our partner network. We currently serve healthcare professionals, wellness brands, and clinics in Europe, the United Kingdom, Asia, Australia, New Zealand, and the United States. Contact us to discuss testing services, white-label kits, or method transfer to your laboratory.

Interested in this method?

Whether you need testing services, method transfer, or white-label kit development — we'd love to hear from you.