Investigation

Investigation in the ED will be tailored to the patients presenting symptoms and signs and is usually directed at the more common conditions which phaeochromocytoma may mimic.

Investigation will usually include, ECG, capillary blood glucose and FBC.

Phaeochromocytoma might mimic these common conditions:

• ACS
• Subarachnoid haemorrhage
• Gastroenteritis
• Stroke
• Essential hypertension
• Anxiety/panic attacks
• Sepsis
• Drug ingestion (e.g. Cocaine)

Investigation of phaeochromocytoma per se is not usually instigated in the ED but consists of plasma and urine metanephrines, catecholamines and urine VMA.

The most sensitive test is plasma metanephrine at 99% with a specificity of 89%.

Initial imaging is usually CT scan of the abdomen (sensitivity 93-100%), MRI scanning has a similar sensitivity.