We assessed the clinical utility of serum chromogranin A (CgA) alone and in combination with plasma catecholamines in the diagnosis of pheochromocytoma in patients with mild to moderate renal impairment. The study population consisted of 44 normal subjects, 50 subjects with proven pheochromocytoma, and 82 subjects with hypertension (60 primary and 22 secondary) suspected but not proven to have the disease. In this highly selected group with high disease prevalence (38%), the overall sensitivity, specificity, accuracy, and positive and negative predictive values of serum CgA in the diagnosis of pheochromocytoma were 86%, 74%, 79%, 67%, and 94%, respectively. However, in patients with creatinine clearance less than 1.33 mL/s (80 mL/min), these values dropped to 85%, 50%, 59%, 38%, and 90%, respectively. The combination of plasma catecholamines and CgA provided the best overall specificity (95%), accuracy (88%), and positive predictive value (91%). In patients with a creatinine clearance of more than 1.33 mL/s, the combination gave a specificity of 98%, an accuracy of 89%, and a positive predictive value of 97%. These results show that serum CgA has poor diagnostic specificity in the diagnosis of pheochromocytoma when renal function is impaired. Combining CgA with plasma catecholamines provides a lower sensitivity, but excellent specificity, accuracy, and positive predictive value.

Canale, M.p., Bravo, E. (1994). Diagnostic specificity of serum chromogranin-A for pheochromocytoma in patients with renal dysfunction. THE JOURNAL OF CLINICAL ENDOCRINOLOGY AND METABOLISM, 78(5), 1139-1144 [10.1210/jcem.78.5.8175970].

Diagnostic specificity of serum chromogranin-A for pheochromocytoma in patients with renal dysfunction

CANALE, MARIA PAOLA;
1994-05-01

Abstract

We assessed the clinical utility of serum chromogranin A (CgA) alone and in combination with plasma catecholamines in the diagnosis of pheochromocytoma in patients with mild to moderate renal impairment. The study population consisted of 44 normal subjects, 50 subjects with proven pheochromocytoma, and 82 subjects with hypertension (60 primary and 22 secondary) suspected but not proven to have the disease. In this highly selected group with high disease prevalence (38%), the overall sensitivity, specificity, accuracy, and positive and negative predictive values of serum CgA in the diagnosis of pheochromocytoma were 86%, 74%, 79%, 67%, and 94%, respectively. However, in patients with creatinine clearance less than 1.33 mL/s (80 mL/min), these values dropped to 85%, 50%, 59%, 38%, and 90%, respectively. The combination of plasma catecholamines and CgA provided the best overall specificity (95%), accuracy (88%), and positive predictive value (91%). In patients with a creatinine clearance of more than 1.33 mL/s, the combination gave a specificity of 98%, an accuracy of 89%, and a positive predictive value of 97%. These results show that serum CgA has poor diagnostic specificity in the diagnosis of pheochromocytoma when renal function is impaired. Combining CgA with plasma catecholamines provides a lower sensitivity, but excellent specificity, accuracy, and positive predictive value.
mag-1994
Pubblicato
Rilevanza internazionale
Articolo
Esperti anonimi
Settore MED/09 - MEDICINA INTERNA
English
Adrenal Gland Neoplasms; Adult; Aged; Catecholamines; Chromogranin A; Chromogranins; Female; Humans; Kidney Diseases; Male; Middle Aged; Pheochromocytoma; Prospective Studies; Sensitivity and Specificity
Canale, M.p., Bravo, E. (1994). Diagnostic specificity of serum chromogranin-A for pheochromocytoma in patients with renal dysfunction. THE JOURNAL OF CLINICAL ENDOCRINOLOGY AND METABOLISM, 78(5), 1139-1144 [10.1210/jcem.78.5.8175970].
Canale, Mp; Bravo, E
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/121962
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