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Pheochromocytomas and other tumors derived from neural crest cells (eg, paragangliomas and neuroblastomas) secrete catecholamines (epinephrine, norepinephrine, and dopamine). Metanephrine and normetanephrine (collectively referred to as metanephrines) are the 3-methoxy metabolites of epinephrine and norepinephrine, respectively. The metanephrines are stable metabolites and are cosecreted directly with catecholamines by pheochromocytomas and other neural crest tumors. This results in sustained elevations in plasma free metanephrine levels, making them more sensitive and specific than plasma catecholamines in the identification of pheochromocytoma patients.
Drugs like Labetalol, Sotalol, Acetaminophen, Methyldopa, Antidepressants, and substances like Ephedrine, Amphetamine, Nicotine, and Caffeine should all be rigorously avoided by the patient. At least 72 hours before sample collection, stay away from foods