[Biochemical diagnosis of pheochromocytoma and neuroblastomas]. / Diagnostic biochinique du phéochromocytome et du neuroblastome.

Pheochromocytoma and neuroblastoma are distinct tumours, but their biological diagnosis is based on secretion increase of one or several catecholamines. Assays have to be very sensible and specific for an early diagnosis. 24 hours urinary catecholamines and metabolites are currently measured, but technical improvements permit plasma metanephrine assay, an excellent indicator of pheochromocytoma. HPLC coupled to electrochemical detection represents the most efficient methodology. After a review of urinary and plasma assay methods, the authors show usual values of catecholamines, metanephrines, HVA and VMA, according to ages, and give examples of results encountered in classical or not tumours and in falsely positive cases. Urinary metanephrine assay is the most sensible and specific in biological diagnosis of pheochromocytoma, while catecholamines and VMA assays lack of sensibility. Results have to be given by 24 hours and by creatinine ratio. Metanephrine assay can be performed also in plasma and exhibits the same interest. However, in urine as in plasma, in case of renal failure, results cannot be interpreted. Neuroblastoma biological diagnosis is based classically on HVA, VMA, and dopamine assays, nowadays only in 24 hours urine (or in urinary micturition for screening), and results are also expressed as creatinine ratio. But even if several assays are advisable, 5% of the neuroblastoma cases do not produce increased catecholamine values. In some cases, metanephrine assay could be of interest. After the age of 12 months, clinical expression of neuroblastoma is dramatic in 70% of cases. So, a biological screening has been experimented in several countries including France. A French translation of the consensus conference report (1998) is appended, which shows the complexity of neuroblastoma screening. Now, there is no evidence that early tumour detection by screening lessens the mortality rate, but a weak benefit is not excluded.

[The diagnosis of atypical pheochromocytoma: a challenge for the biologist as well]. / Le diagnostic du phéochromocytome atypique: un challenge aussi pour le biologiste.

Biological diagnosis of pheochromocytoma is relatively easy in those cases releasing great amounts of catecholamines with strong clinical features; instead, diagnosis could be more problematic in atypical or asymptomatic familial pheochromocytoma with small tumors secreting low catecholamine amounts. Several plasma and urine adrenergic markers must be used to confirm the clinical suspicion. We have discussed the biological data of three totally asymptomatic pheochromocytomas (cases no 2, 3, 4) and one case with a very discrete clinical manifestation (no 1). Three patients had very small tumors (4, 7 and 25 g) secreting preeminently adrenaline, one patient had a 45 g adrenal incidentaloma without clinical expression. Our study shows that, in these special cases, except for an inconstant increase of adrenaline, plasma and urine catecholamines and urine VMA can be normal. The most useful markers are plasma and urine methoxyamines. However, plasma methoxyamines are the most sensitive because their increase over reference values is by far greater than in urines. Several factors may explain these findings: a low tumoral secretion, the nature of the released amine, the short half-life of catecholamines in plasma and, in some cases, the involvement of intratumoral catecholamine metabolism. Analysis of the ratio NMN/MN in plasma provides an additional diagnosis tool to reveal adrenaline secretion abnormalities.

Specific sound-induced noradrenergic and serotonergic activation in central auditory structures.

We have studied the noradrenergic and serotonergic changes induced by white noise stimulation at 70, 90 or 110 dB SPL for 45 min, in cochlear nuclei, inferior colliculus (IC), primary auditory cortex (PAC) and as a comparison in locus coeruleus (LC) and raphe dorsalis using HPLC. Both noradrenergic and serotonergic pathways were activated in the dorsal+posteroventral cochlear nuclei (DCN+PVCN) without changes in the anteroventral cochlear nucleus (AVCN) and IC. In the DCN+PVCN the noradrenergic activation was restricted to animals exposed to 70 dB SPL whereas the increase of serotonin content was intensity-dependent. In PAC serotonergic activation was observed only after 70 dB SPL exposure. These data suggest that in physiological conditions (70 dB SPL) noradrenergic and serotonergic regulation of the processing of auditory information occurs specifically in the dorsal cochlear nucleus where the control of incoming information to higher auditory structures takes place (i.e. IC and PAC). We suggest that the serotonergic activation in the primary auditory cortex for 70 dB SPL sound stimulation could be related to the fact that low-intensity white noise stimulation could be the most plastic-demanding processing in the auditory cortex.

Reward dependence is positively related to urinary monoamines in normal men.

According to Cloninger, three major personality dimensions, novelty seeking, harm avoidance, and reward dependence, are dependent on central monoaminergic systems. This study examined the relationship between the urinary levels of different monoamines and the above personality dimensions. Fifty normal men answered the Tridimensional Personality Questionnaire (TPQ); their levels of dopamine, norepinephrine, epinephrine, normetanephrine, metanephrine, 3-methoxy-4-hydroxyphenylglycol, vanilmandelic acid, homovanilic acid, and serotonin metabolite 5-hydroxyindolacetic acid were measured in urine on two consecutive nights. Significant and positive correlations were found between reward dependence, 3-methoxy-4-hydroxyphenylglycol, and epinephrine (r = .50 and r = .51, respectively). Monoamine levels explained 44% of the variance of reward dependence. Cluster analysis identified three groups of subjects presenting specific patterns of monoamine excretion. The TPQ scores could discriminate among subjects belonging to these clusters. These results point out a narrow relationship between urinary monoamine excretion and the basic personality dimension of reward dependence.

Long-term exposure to ozone alters peripheral and central catecholamine activity in rats.

In addition to its noxious influence on lung airways, ozone inhalation can induce extrapulmonary neural dysfunctions the mechanisms of which are poorly understood. This study was intended to characterize the effects of long-term exposure to ozone (0.5 ppm, 5 days) on catecholamine activity in rat sympathetic efferents and brain areas of prime importance to adaptation to environmental stressors. Catecholamine activity was assessed by estimating the turnover rate of catecholamines and in vivo tyrosine hydroxylase activity in peripheral and central structures, i.e., heart, lungs, superior cervical ganglia, cerebral cortex, hypothalamus and striatum, A2 cell group within the nucleus tractus solitarius (NTS), and locus ceruleus (A6). Ozone inhibited norepinephrine turnover in heart (-48% of the control level) but not in lungs. Ozone failed to modify the tyrosine hydroxylase activity in superior cervical ganglia, and the catecholamine content in the adrenal glands. In the central nervous system, ozone inhibited tyrosine hydroxylase activity in noradrenergic brainstem cell groups, including the locus ceruleus (-62%) and the caudal A2 subset (-57%). Catecholamine turnover was decreased by ozone in the cortex (-49%) and striatum (-18%) but not in the hypothalamus. The data show that ozone can produce marked neural disturbances in structures involved in the integration of chemosensory inputs, arousal, and motor control.

Brain monoamines and optokinetic performances in pigmented and albino rats.

The aim of this study was two-fold: 1) To provide in DA-HAN rats the basic brain monoamine data useful for later investigations of the neurochemical effects of sensory alterations and 2) to assess whether there is a relationship between the monoaminergic pattern in medial vestibular nuclei and optokinetic performances. We comparatively studied the regional brain monoamine distribution and the optokinetic performances in pigmented DA-HAN and albino Sprague-Dawley rats. As expected, the optokinetic responses and vestibulo-ocular reflex gain were by far more efficient in DA-HAN rats. Norepinephrine (NE), dopamine (DA), serotonin (5-HT) and their metabolites were determined in retina, brainstem nuclei and dopaminergic areas. DA-HAN rats exhibited an increased noradrenergic activity in the medial vestibular nuclei, locus coeruleus and anteroventral cochlear nucleus, an extended decrease of serotonergic activity in brainstem nuclei and increased DA stores with a reduced dopaminergic activity in most dopaminergic areas. These data confirm and extend the general findings that biochemical data obtained in one strain cannot be extrapolated to another strain. The possible role of the morphological neuronal abnormalities and functional impairment induced by albinism has been discussed especially in medial vestibular nucleus, cochlear nuclei and retina. Alternatively, behavioral factors may also explain some of the observed neurochemical differences.

Lower sex hormones in men during anticipatory stress.

Free cortisol, luteinizing hormone (LH), total testosterone and monoamines were measured in two successive nocturnal urine collections in 50 healthy men to assess the influence of anticipatory stress. The first collection (N-2) was two nights before and the second (N-1) was just on the night before a one-day experimental stressor consisting of participation in a one-day clinical research protocol. The mean cortisol level increased from 23.4 (N-2) to 66.6 micrograms (N-1), while mean LH level decreased from 2.68 (N-2) to 1.71 IU (N-1) and the mean testosterone level fell from 1.31 (N-2) to 0.70 microgram (N-1). There were no changes in monoamines. Inhibition of sex hormones is a relatively neglected area of stress research.

Aging effects on monoamines in rat medial vestibular and cochlear nuclei.

Noradrenaline (NA), dopamine (DA); serotonin (5-HT) and their metabolites-3-methoxy, 4-hydroxyphenylglycol (MHPG), 3,4-dihydroxyphenylacetic acid (DOPAC) and 5-hydroxyindoleacetic acid (5-HIAA)-were determined using HPLC in medial vestibular nucleus (MVN), anteroventral cochlear nucleus (AVCN), dorsal+posteroventral cochlear nucleus (DCN+PVCN), locus coeruleus (LC) and raphe dorsalis of Dark Agouti-Hanovre (DA-HAN) rats aged 4, 21 and 24 months. In older rats, the main noradrenergic changes were a decrease of NA content with an increase of the MHPG/NA ratio in MVN and a selective NA increase in AVCN. 5-HT and 5-HIAA levels were increased in all the brainstem nuclei except raphe dorsalis. DA and DOPAC remained unchanged. These data show that noradrenergic neurons in sensory nuclei are differently affected by aging whereas serotonergic activation occurs in most of them possibly as a compensatory response to dysfunction of sensory input and processing. The increase of NA stores in the AVCN of aged rats is in line with the elevated auditory brainstem threshold reported in old rats and could improve the signal-to-noise ratio. Noradrenergic neurons in the MVN seem to be more sensitive to age effect than cochlear nuclei; however, even if neuronal loss occurs, NA synthesis and/or metabolism increase to ensure normal or increased noradrenergic activity.

Effect of hemilabyrinthectomy on monoamine metabolism in the medial vestibular nucleus, locus coeruleus, and other brainstem nuclei of albino and pigmented rats.

We compared in albino and pigmented rats the early effect of unilateral labyrinthectomy (UL) on the concentrations of monoamines (norepinephrine, dopamine, serotonin) and their respective metabolites--3-methoxy,4-hydroxyphenylglycol (MHPG), 3,4-dihydroxy-phenylacetic acid (DOPAC), and 5-hydroxyindoleacetic acid (5HIAA)--in medial vestibular nuclei (MVN), locus coeruleus, raphe dorsalis, and cochlear nuclei. The study was conducted 6 hours after UL in both strains, differing by the functional optokinetic responses of their central vestibular neurons and the time-course of their vestibular compensation. The results show that the monoaminergic changes are different in the two rat strains. In the MVN of albino rats, there was a bilateral increase of MHPG and an ipsilateral increase of dopamine suggesting activation of norepinephrine synthesis and metabolism, whereas no such changes were observed in the MVN of pigmented rats. On the other hand, the simultaneous increase of norepinephrine and DOPAC observed in the contralateral locus coeruleus of albino rats suggested enhanced norepinephrine synthesis, whereas in pigmented rats the decreased norepinephrine content found in the ipsilateral locus coeruleus might reflect an earlier strong stimulation of NE release. These biochemical results confirm the relevant role of locus coeruleus noradrenergic innervation in vestibular compensation and also point out the involvement of norepinephrine of the MVN in the early stages of this process. The different strain-related noradrenergic responses observed on the 6th hour suggest that the involvement of central norepinephrine, particularly from locus coeruleus innervation, may be more crucial and more sustained in the albino than in pigmented rats. No serotonin and 5HIAA changes were found in either brainstem nuclei of albino rats. In contrast, the increase of the ratio 5HIAA/5HT observed in raphe dorsalis, in ipsilateral locus coeruleus, and in both sides of MVN of pigmented rats suggested that UL induced an extended and enhanced utilization of 5HT in this strain.

[The biological diagnosis of pheochromocytoma]. / La stratégie du diagnostic biologique du phéochromocytome.

Pheochromocytomas are tumors secreting large amount of catecholamines. Elevation of blood pressure is the classical manifestation but frequently the tumors are silent and they have to be screened systematically. The biological diagnosis is essential to affirm the tumor before any imaging procedure. It needs to select the most sensitive and specific methods. The sensitivity of VMA, urinary catecholamines and plasma catecholamines assays is respectively 70%, 75%, 85%. Determination of methoxyamines in the urine or better in the plasma reaches a sensitivities of 98%. This represents the best tool for the diagnosis of pheochromocytomas. Only renal or heart failure decrease the specificity of the plasma methoxyamines assay.

Monoamines (norepinephrine, dopamine, serotonin) in the rat medial vestibular nucleus: endogenous levels and turnover.

Monoamine (norepinephrine, dopamine, serotonin) and metabolite endogenous levels were determined in the rat medial vestibular nucleus (MVN) using HPLC with electrochemical detection. As a comparison, the locus coeruleus (LC) and dorsal raphe nucleus (RD) which contain the cell bodies of MVN noradrenergic and serotoninergic neurons respectively were also analyzed. Norepinephrine (NE) and serotonin (5-HT) basal levels of MVN were high (33.8 and 39.2pmol/mg protein respectively) but lesser than in LC or RD. Great amounts of MHPG and 5-HIAA were also present in the MVN. The turnover of NE assessed both from the ratio MHPG/NE and by the decrease in the NE content after treatment with alpha-methylparatyrosine was faster in the MVN (half-life: 1.5h) than in LC (half-life: 3.6h). On the other hand, the ratio 5-HIAA/5-HT was lower in the MVN (0.58) than in the RD (0.85) indicating a smaller 5-HT turnover in the MVN. In addition, like LC and RD, the MVN contained meaningful amounts of dopamine (DA) and DOPAC. The high ratio DA/NE (0.27) suggests the presence of non precursor specific dopaminergic pools. However, individualized dopaminergic neurons have not yet been demonstrated. The data are discussed in line with the possible neurotransmitter function of monoamines in the MVN.

Monoamines (noradrenaline, dopamine, serotonin) in the rat cochlear nuclei: endogenous levels and turnover.

Noradrenaline (NA), dopamine (DA), serotonin (5-HT) and their metabolites, 3-methoxy,4-hydroxyphenylglycol (MHPG) and 5-hydroxyindoleacetic acid (5-HIAA), were determined using high-performance liquid chromatography with electrochemical detection in the rat anteroventral cochlear nucleus (AVCN), in the dorsal part of the nucleus including the dorsal cochlear nucleus (DCN) and the posteroventral cochlear nucleus (PVCN) and as a comparison, in the locus coeruleus (LC) and dorsal raphe nucleus (RD) which contain the corresponding noradrenergic and serotonergic cell bodies. In both cochlear nuclei (CN), the endogenous levels of NA, 5-HT and related metabolites were smaller than in LC or RD. NA turnover assessed from the ratio MHPG/NA or after treatment with alpha-methylparatyrosine was faster in the CN than in LC; in contrast, 5-HT turnover was lower in the CN than in RD as shown by the ratio 5-HIAA/5-HT. In agreement with previous histological findings, NA and 5-HT were more concentrated in AVCN than in DCN+PCVN; however, the turnover of both monoamines was faster in the dorsal nuclei. In addition, the CN contained small amounts of dopamine and DOPAC; both DA levels and the ratio DA/NA (0.10 vs. 0.04) were greater in the dorsal than in the ventral part suggesting the presence of non-precursor-specific DA pools. Our data suggest that the functional involvement of monoamines may be different in cochlear subnuclei.

Norepinephrine release in the rat frontal cortex under treadmill exercise: a study with microdialysis.

Cortical norepinephrine (NE) release and metabolism were studied by using chronic microdialysis in rats performing a treadmill exercise at 25 m/min with a 3% slope. Cortical microdialysates and peripheral blood were collected at rest, during 1- or 2-h treadmill running, and for 1 h after exercise. Microdialysate NE and its main metabolites, 3,4-dihydroxyphenylglycol and 3-methoxy-4-hydroxyphenylglycol, and plasma epinephrine (Epi) and NE were determined by high-performance liquid chromatography with electrochemical detection. The results show that treadmill running is able to stimulate concomitantly peripheral catecholamine secretion and central noradrenergic activity, i.e., NE turnover and release. The duration of the central activation and its prolongation over recovery period increases as the duration of the running increases. A positive correlation was found between the central noradrenergic activation and peripheral Epi secretion but not peripheral NE. These findings confirm and extend our previous observations in exercising men and give support to the hypothesis that the elevation of circulating Epi can be a relevant factor mediating, directly or indirectly, the exercise-induced central neurochemical, psychological, and cognitive changes.

Spectral analysis of stress-induced change in blood pressure and heart rate in normotensive subjects.

Changes in spectral analysis of the variability in systolic blood pressure (SBP) and heart rate (HR) were investigated in 12 normotensive volunteers during a well-standardized stress test. BP was measured indirectly from the finger by a noninvasive device (Finapres). The stress test was a computerized version of the Stroop color word conflict test (CWT). The influences of acute (single dose) beta 1-selective blockade by bisoprolol or angiotensin-converting enzyme (ACE) inhibition by lisinopril were analyzed by a double-blind placebo-controlled trial. During the placebo phase, the efficiency of the stress test was confirmed by a significant increase in SBP (25 +/- 11%), HR (36 +/- 23%), and plasma concentrations of epinephrine (Epi, 54 +/- 37%) and norepinephrine (NE, 27 +/- 35%). Stress induced a significant increase in the amplitude of SBP and HR oscillations in the medium-frequency band (MF, 70- to 140-mHz range), which corresponds to the Mayer waves (27 +/- 32 and 42 +/- 43%, respectively for SBP-MF and HR-MF). The stress-induced increase in NE correlated significantly with the increase in HR (r = 0.68, p < 0.05). The stress-induced increase in SBP-MF correlated significantly with the increase in Epi (r = 0.69, p < 0.05) and in HR-MF (r = 0.69, p < 0.05). A significant decrease in SBP-MF at rest was observed with a single oral (p.o.) dose of bisoprolol, but not of lisinopril. As a noninvasive method, spectral analysis of the variability in SBP and HR may be of benefit in stress-induced modifications of the autonomic nervous system.

Differential regional and kinetics effects of piribedil and bromocriptine on dopamine metabolites: a brain microdialysis study in freely moving rats.

Brain microdialysis coupled to HPLC was applied to freely moving rats to investigate the regional kinetics of piribedil and bromocriptine on the extracellular levels of 3,4-dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA) in striatum, nucleus accumbens, and frontal cortex. Both D2 agonists (20 mg/kg i.p.) decreased DOPAC and HVA in the three brain regions. The responsiveness of frontal cortex to both compounds was greater than those previously reported with other dopaminergic drugs. Regional and temporal differences were observed under piribedil: DOPAC and HVA levels decreased more in the nucleus accumbens than in striatum or frontal cortex but increased over basal values from the 5th hour in the frontal cortex suggesting a late stimulatory effect of piribedil on dopamine synthesis in this area. Such regional effects differentiate piribedil from most other D2 agonists and could explain some behavioural and therapeutic actions possibly related to involvement of nucleus accumbens or/and frontal cortex.

Physical conditioning in rats influences the central and peripheral catecholamine responses to sustained exercise.

We have investigated the effect of treadmill running in rats (25m.min-1 using a 3% gradient; for 1 h or 2 h) on the cortical extracellular concentrations of noradrenaline (NA) and its main metabolites-3,4-dihydroxyphenylglycol and 3-methoxy-4-hydroxyphenylglycol- and the plasma adrenaline (A) and NA concentrations in relation to prior physical conditioning (1 or 2-h running.day-1 for 12 days). Cortical microdialysates and peripheral blood were collected during 1-h resting, 1-h or 2-h running and for 1 h after exercise. Catecholamines and their metabolites were quantitated using high performance liquid chromatography with electrochemical detection. Treadmill running stimulated concomitantly peripheral catecholamine secretion and central noradrenergic activity, i.e. NA turnover and release. The effect extended into the recovery period even more as the duration of the run increased. Prior physical conditioning greatly influenced the central and peripheral catecholamine responses: the 1-h trained rats experienced the 2-h run as a stressful new event eliciting great long-lasting catecholamine responses, whereas the 2-h trained rats exhibited a progressive sustained catecholamine increase with an earlier onset of the central NA release. The data are discussed in relation to the psychological and intellectual effects of exercise and physical fitness in humans. In addition, the positive correlation found between the central noradrenergic activation and peripheral A secretion confirmed and extended our previous observations in exercising men and gave support to the hypothesis that the elevation of circulating A can be a relevant factor mediating--directly or indirectly--the exercise-induced central effects.

[Plasma methoxyamines assay: a practical advance for the diagnosis of pheochromocytoma]. / Le dosage des méthoxyamines plasmatiques: une avancée pratique dans le diagnostic du phéochromocytome.

Measurement of plasma methoxyamines is aimed to provide a reliable plasma marker readily available for any patient suspected of having a pheochromocytoma. The present HPLC method is able to detect methoxyamine amounts as low as 0.2 nmoles/l and allows the determination of both free or conjugated methoxyamines (metanephrine MN and normetanephrine NMN) in normal subjects, treated or untreated patients and a fortiori in pheochromocytoma. The analytical specificity is excellent. Among most usual antihypertensive drugs, only conversion enzyme inhibitors and diuretics induce in some patients a moderate increase of NMN with minor consequence in values interpretation. The kidney plays a major role in the blood clearance of methoxyamines and any alteration of renal function is associated to the increase of plasma methoxyamine levels. Plasma methoxyamines have a long half-life and are long-lasting integrated markers of catecholamine secretion; at variance with plasma free catecholamines, they are able to afford the presence of a secreting pheochromocytoma whatever the clinical presentation--asymptomatic or paroxysmal form between the crisis. The diagnostic sensitivity (at least 98%) is equal to that of urinary methoxyamines, far higher than plasma or urine catecholamines or urine VMA (60 to 70%).

Chemosensitivity, plasticity, and functional heterogeneity of paraganglionic cells in the rat coeliac-superior mesenteric complex.

Chemosensitivity and plasticity of paraganglionic cells in the rat coeliac-superior mesenteric complex (CSMC) were investigated at a basal state of normoxia (21% O2) and after long-term moderate hypoxia (10% O2, 14 days). Chemical sympathectomy previous to hypoxia was performed to destroy principal ganglionic neurons and thus to allow measurement of the norepinephrine and dopamine content of paraganglionic cells. At the basal state, the CSMC contained dopaminergic (TH+/DBH-) and noradrenergic (TH+/DBH+) paraganglionic cells, the majority being of the noradrenergic type. After 14 days of hypoxia, this ratio was reversed and dopaminergic cells predominated, as indicated by a twofold increase of TH+ cells and a twofold decrease of DBH+ cells. Biochemically, hypoxia produced an increase in the content (1.6-fold) and utilization (1.4-fold) of dopamine as well as a smaller increase in the content of norepinephrine, with no change in its utilization rate. The dopaminergic activation induced by hypoxia persisted after sympathectomy with guanethidine. It is concluded that paraganglionic cells in the CSMC display a chemosensitive function. Furthermore, our findings indicate that paraganglionic cells are differentially affected by hypoxia, depending on their distribution and the nature of their neuromodulators. The alterations induced by hypoxia point out the phenotypic plasticity developed by paraganglionic cells in adaptation to hypoxia and further demonstrate the functional heterogeneity of this autonomic cell population in the rat CSMC.

Adrenal response to long-term hypoxia is still increased after carotid body denervation in rat.

This study investigated the effects of long-term normobaric hypoxia (10% O2 in N2 for 2, 7, 14, and 28 days) on the metabolism of catecholamines in rat adrenals and the role of the carotid body chemoreceptors in the adrenal response. The content and utilization of dopamine were significantly increased from the 7th day of hypoxia and remained enhanced thereafter. The content of norepinephrine and epinephrine decreased after 2 days of hypoxia and increased thereafter; after 28 days of hypoxia the norepinephrine amounts remained enhanced but the epinephrine levels were no longer significantly increased. In vivo tyrosine hydroxylation increased after 7 days of hypoxia. Bilateral transection of the carotid sinus nerve 1 wk before hypoxia failed to abolish the increase in the content and utilization of dopamine after 7, 14, or 21 days of hypoxic exposure. These results indicate that long-term normobaric hypoxia elicits a long-lasting increase in the metabolism of catecholamines in adrenals, especially as assessed by dopamine measurement, and that this response does not involve a carotid body chemoreflex pathway.

[Recommended methods for the determination of catecholamines and their metabolites in urine. Significance of results in the diagnosis and follow-up of pheochromocytoma and neuroblastoma]. / Méthodes recommandées pour le dosage des catécholamines et de leurs métabolites dans l'urine. Signification des résultats dans le diagnostic et le suivi des phéochromocytomes et des neuroblastomes.

Laboratory investigation of catecholamines is useful for the clinician in the diagnosis and management of phaeochromocytoma and neuroblastoma. This work summarizes current knowledge on catecholamines and their metabolites and discusses the main indications for their determination. It also examines the most practical methods for studying the secretion of these hormones, ie extraction, separation and quantification using high performance liquid chromatography coupled with electrochemical detection. The workshops attended by the members of the catecholamines working party of the French Clinical Biology Society and phaeochromocytoma and neuroblastoma specialists enabled the role of such determinations in the diagnosis and management of these diseases to be clarified.