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

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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.

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 is metanephrines?

Metanephrines is an important biomarker for diagnosis and exclusion of phaeochromocytoma. Masdiag measures metanephrines using validated analytical methods to provide clinically actionable results.

Why is metanephrines important?

Metanephrines testing is valuable for Diagnosis and exclusion of phaeochromocytoma, Diagnosis of extra-adrenal paraganglioma. Understanding metanephrines levels helps inform personalized health optimization and clinical decision-making.

How is the metanephrines sample collected?

Metanephrines is measured from Plasma. Professional collection ensures proper sample handling and accurate results.

Who should get a metanephrines test?

This test is recommended for individuals interested in diagnosis and exclusion of phaeochromocytoma. Masdiag metanephrines testing helps guide personalized supplementation and health optimization strategies based on objective biomarker data.

What do metanephrines results tell us?

Metanephrines results provide insight into your metabolic status and diagnosis and exclusion of phaeochromocytoma. Combined with clinical context, Masdiag results inform evidence-based interventions for personalized health optimization.

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