Plasma free metanephrines (pheochromocytoma/paraganglioma surveillance — VHL/MEN2/SDH)
Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.
| ID | BIO-METANEPHRINES-PLASMA-PHEO |
|---|---|
| Type | Biomarker |
| Aliases | Plasma Free Metanephrinesfractionated plasma metanephrinesplasma metanephrineplasma normetanephrineМетанефрини плазми вільні (нагляд феохромоцитоми/парагангліоми — VHL/MEN2/SDH) |
| Status | reviewed 2026-05-18 | pending_clinical_signoff |
| Diseases | DIS-PHEOCHROMOCYTOMA |
| Sources | SRC-ENDOCRINE-SOCIETY-MEN-2023 SRC-NCCN-KIDNEY-2025 SRC-NCCN-NET-2025 |
Biomarker Facts
| Biomarker type | serum_marker |
|---|---|
| Measurement | MethodPlasma LC-MS/MS (preferred) or immunoassay; patient supine ≥30 min before draw Unitspg/mL or nmol/L (assay-dependent reference ranges; metanephrine and normetanephrine reported separately) |
| Related biomarkers | None declared |
Notes
Catecholamine-metabolite biomarker — gold-standard biochemical test for pheochromocytoma and paraganglioma (PPGL). Preferred for asymptomatic surveillance in syndromic carriers: VHL (annual, lifelong), MEN2A/MEN2B (annual after age 5-8 per RET codon stratification), SDHB/SDHC/SDHD/SDHA (annual, starting age 6-10 per Endocrine Society 2023). Sensitivity ~96-99% for PPGL when properly drawn; specificity ~85-95% (lower with drug/dietary interferents). VHL Type 1 lacks pheo; Type 2A/2B/2C have pheo as defining feature — surveillance schedule keyed to VHL phenotype classification (see BIO-VHL-CLASSIFICATION-PHENOTYPE). Elevation >3-4x upper limit highly suggestive; intermediate elevation prompts clonidine suppression test or 24-h urinary fractionated metanephrines as confirm. Imaging (MRI abdomen + I-123 MIBG or 68Ga-DOTATATE PET) when biochemistry positive. STUB pending two-Co-Lead signoff.
Used By
Actionability
BMA-METANEPHRINES-PHEO-VHL-MEN2-SURVEILLANCE- Plasma free metanephrines are the gold-standard biochemical test for pheochromocytoma and...
Biomarker
BIO-VHL-CLASSIFICATION-PHENOTYPE- VHL phenotype classification (Type 1 / 2A / 2B / 2C)