{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T14:21:05Z","timestamp":1784557265546,"version":"3.55.0"},"reference-count":34,"publisher":"Bioscientifica","issue":"1","license":[{"start":{"date-parts":[[2023,11,13]],"date-time":"2023-11-13T00:00:00Z","timestamp":1699833600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["erc.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,11,13]]},"abstract":"<jats:p>\n                    Measurements of plasma metanephrines and methoxytyramine provide a sensitive test for diagnosis of pheochromocytoma\/paraganglioma. False-positive results remain a problem, particularly in patients taking norepinephrine reuptake-blocking drugs. Therefore, in this retrospective observational study, we measured plasma metanephrines and methoxytyramine in 61 patients taking norepinephrine reuptake blockers (tricyclic antidepressants or serotonin\u2013norepinephrine reuptake inhibitors) and 17 others taking selective serotonin reuptake inhibitors, all without pheochromocytoma\/paraganglioma. We highlight a singular case with strongly elevated plasma normetanephrine and methoxytyramine concentrations associated with norepinephrine reuptake blockade. Data were compared to results from 252 and 1804 respective patients with and without tumors. Plasma normetanephrine was 40% higher (\n                    <jats:italic>P<\/jats:italic>\n                    &lt; 0.0001) in patients on norepinephrine reuptake blockers and methoxytyramine was 127% higher (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.0062) in patients taking tricyclic antidepressants compared to patients not taking uptake blockers and without tumors. The corresponding false-positive rates rose (\n                    <jats:italic>P<\/jats:italic>\n                    &lt; 0.0001) from 4.8% to 23.0% for normetanephrine and from 0.9% to 28.6% for methoxytyramine. Selective serotonin reuptake inhibitors did not increase plasma concentrations of metabolites. In the highlighted case, plasma normetanephrine and methoxytyramine were elevated more than six times above upper reference limits. A pheochromocytoma\/paraganglioma, however, was excluded by functional imaging. All biochemical test results normalized after discontinuation of norepinephrine reuptake blockers. These findings clarify that norepinephrine reuptake blockers usually result in mild elevations of normetanephrine and methoxytyramine that, nevertheless, significantly increase the number of false-positive results. There can, however, be exceptions where increases in normetanephrine and methoxytyramine reach pathological levels. Such exceptions may reflect failure of centrally mediated sympathoinhibition that normally occurs with the norepinephrine reuptake blockade.\n                  <\/jats:p>","DOI":"10.1530\/erc-23-0063","type":"journal-article","created":{"date-parts":[[2023,11,13]],"date-time":"2023-11-13T07:07:25Z","timestamp":1699859245000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-8","source":"Crossref","is-referenced-by-count":5,"title":["False-positive results for pheochromocytoma associated with norepinephrine reuptake blockade"],"prefix":"10.1530","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7488-916X","authenticated-orcid":true,"given":"Robin","family":"Sch\u00fcrfeld","sequence":"first","affiliation":[{"name":"Division of Endocrinology and Diabetes, Department of Internal Medicine, University of Leipzig, Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Pamporaki","sequence":"additional","affiliation":[{"name":"TU Dresden, Medical Clinic III, University Hospital Carl Gustav Carus, Dresden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirko","family":"Peitzsch","sequence":"additional","affiliation":[{"name":"TU Dresden, Institute of Clinical Chemistry and Laboratory Medicine, Dresden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nada","family":"Rayes","sequence":"additional","affiliation":[{"name":"Center of Surgery, Division of Endocrine Surgery, Department for Visceral, Transplant, Thoracic, and Vascular Surgery, University of Leipzig, Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osama","family":"Sabri","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvio","family":"Rohm","sequence":"additional","affiliation":[{"name":"Center of Surgery, Department for Visceral, Transplant, Thoracic, and Vascular Surgery, University of Leipzig, Leipzig, Germany"},{"name":"Center of Surgery, Department for Vascular Surgery, Diakonissen Hospital of Leipzig, Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald","family":"Biemann","sequence":"additional","affiliation":[{"name":"Institute of Clinical Chemistry and Laboratory Medicine, University of Leipzig, Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Sandner","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Diabetes, Department of Internal Medicine, University of Leipzig, Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anke","family":"T\u00f6njes","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Diabetes, Department of Internal Medicine, University of Leipzig, Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8601-9903","authenticated-orcid":true,"given":"Graeme","family":"Eisenhofer","sequence":"additional","affiliation":[{"name":"TU Dresden, Medical Clinic III, University Hospital Carl Gustav Carus, Dresden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"bib1","series-title":"Progress in Brain Research","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/S0079-6123(08)63224-0","article-title":"The uptake, storage, release and metabolism of noradrenaline in sympathetic nerves","volume":"31","author":"Axelrod","year":"1969","unstructured":"Axelrod J & Kopin IJ1969The uptake, storage, release and metabolism of noradrenaline in sympathetic nerves. 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