Pheochromocytoma(갈색세포종) 진단
- 최초 등록일
- 2007.09.14
- 최종 저작일
- 2007.08
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MS 파워포인트
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소개글
Pheochromocytoma(갈색세포종)중에서 진단 부분 위주로 발표한 파워포인트 정리한 파일입니다.
review 형식으로 치료 부분은 없으므로 구매시 참조 바랍니다.
목차
1.Pheochromocytomas
2.Frequency of signs and symptoms of pheochromocytoma
3.Differential diagnosis of pheochromocytoma
4.Pheochromocytoma in genetic disorder
5.Indications for screening
6.Diagnotic approach to pheocromocytoma
7.Catecholamines synthesis and metabolism
8.Sensitivity and specificity of biochemical tests for diagnosis of pheochromocytoma
9.Sources of variable interference with measurements of catecholamines and catecholamine metabolites
10. Evaluation and treatment of catecholamine-producing tumors
본문내용
Pheochromocytomas
catecholamine-producing neuroendocrine tumors arising from chromaffin cells of adrenal medulla or extra-adrenal paraganglia.
tumors from extra-adrenal chromaffin tissue : extra-adrenal phaeochromocytomas or paragangliomas.
24h urine collection:
Creatinine, catecholamines, metanephrines, vanillymandelic acid (VMA)
HPLC with electrochemical detection or mass spect
Positive results (> 2-3 fold elevation):
24h Ucatechols > 2-fold elevation
ULN for total catechols 591-890 nmol/d
24h Utotal metanephrines > 1.2 ug/d (6.5 umol/d)
24h UVMA > 3-fold elevation
ULN 35 umol/d for most assays
Drawn with patient fasting, supine, with an indwelling catheter in place > 30 min
Plasma total catechols > 11.8 nM (2000 pg/mL)
SEN 85% SPEC 80%
False positives: same as for 24h urine testing, also with diuretics, smoking
CRF & ESRD:
Oliguric to Anuric 24h Urines inaccurate
Plasma epinephrine best test for pheo in ESRD
Plasma norepi and metanephrines falsely elevated in ESRD
참고 자료
Lancet 2005; 366: 665~675
Uptodate 17.2 Clinical presentation and diagnosis of pheochromocytoma
Harrison 16th