Evidence map›Paper›PMID 42007997›Full record

ReviewEndocrine-related cancer2026

Determinants of false-positive plasma free metanephrines and methoxytyramine: the role of medications and chronic disease.

Lara M Knigge, Kristin Potthoff, Georgiana Constantinescu, Sybille Fuld, Karolina Zawadzka, Ermal Tahirukaj, Stefan Bornstein, Jacques W M Lenders, Graeme Eisenhofer, Christina Pamporaki

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Endocrine-related cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Lara M KniggeDepartment of Medicine ΙΙI, University Hospital Carl Gustav Carus at The TU Dresden, Dresden, Germany.
Kristin PotthoffDepartment of Medicine ΙΙI, University Hospital Carl Gustav Carus at The TU Dresden, Dresden, Germany.
Georgiana ConstantinescuDepartment of Medicine ΙΙI, University Hospital Carl Gustav Carus at The TU Dresden, Dresden, Germany.
Sybille FuldDepartment of Medicine ΙΙI, University Hospital Carl Gustav Carus at The TU Dresden, Dresden, Germany.
Karolina ZawadzkaDepartment of Endocrinology, Oncological Endocrinology, Nuclear Medicine and Internal Medicine, University Hospital in Krakow, Krakow, Poland.
Ermal TahirukajDepartment of Medicine ΙΙI, University Hospital Carl Gustav Carus at The TU Dresden, Dresden, Germany.
Stefan BornsteinDepartment of Medicine ΙΙI, University Hospital Carl Gustav Carus at The TU Dresden, Dresden, Germany.
Jacques W M LendersDepartment of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
Graeme EisenhoferDepartment of Medicine ΙΙI, University Hospital Carl Gustav Carus at The TU Dresden, Dresden, Germany.
Christina PamporakiDepartment of Medicine ΙΙI, University Hospital Carl Gustav Carus at The TU Dresden, Dresden, Germany.ORCID 0000-0003-0772-1604

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Measurements of plasma free metanephrines provide a highly sensitive test for the diagnosis of pheochromocytoma/paraganglioma (PPGL). However, false-positive results remain common, posing a diagnostic dilemma for clinicians. The aim of this study was to determine whether chronic illness and commonly prescribed drugs can falsely elevate plasma free metanephrines. This retrospective study included 460 patients without PPGL. Disease exclusion was based on negative imaging or histopathological findings, or negative biochemistry at follow-up. Sex, age, plasma free normetanephrine, metanephrine, and methoxytyramine, the presence or absence of cardiometabolic comorbidities and/or chronic illness (CCI), and all prescribed medications at study inclusion were reported. In four patients under treatment with norepinephrine reuptake blockers (NRBs), metanephrines were measured at baseline and after short-term discontinuation of the drug. Among the 460 patients without PPGL, 88% (407/460) were receiving at least one medication. In this cohort, false-positive elevations of plasma free metanephrines were rare (7%). Multivariable analysis identified NRBs as the only drugs independently associated with increased plasma free normetanephrine levels (P < 0.001), in a dose-dependent manner. Importantly, plasma free methoxytyramine concentrations were independently influenced by NRBs, antipsychotics, and nicotine use (P < 0.001). Paired analyses in a subset of four patients before and after short-term NRB withdrawal showed normalization of plasma free normetanephrine concentrations. Plasma free metanephrines show high diagnostic reliability with minimal interference from CCI or commonly used medications. However, NRBs can increase normetanephrine and methoxytyramine concentrations, particularly at higher doses, and thus, their use requires cautious interpretation of plasma free metanephrine measurements.

Indexed as

Adrenal Gland NeoplasmsDopamineMetanephrineParagangliomaPheochromocytomaAdultAgedChronic DiseaseFalse Positive ReactionsFemaleHumansMaleMiddle AgedNormetanephrineRetrospective Studies3-methoxytyramineDopamineMetanephrineNormetanephrineautonomic nervous systemfalse-positive resultsmedicationmetanephrinenormetanephrineparagangliomaphaeochromocytoma

Identifiers

PMID42007997
PMCPMC13188186

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.