Urinary 5-HIAA Excretion is not Increased in Patients with Head and Neck Paragangliomas

2012 ◽  
Vol 27 (2) ◽  
pp. 160-163 ◽  
Author(s):  
Leonie T. Van Hulsteijn ◽  
Nicolette Van Duinen ◽  
Johannes A. Romijn ◽  
Johannes W.A. Smit ◽  
Eleonora P.M. Corssmit
Keyword(s):  
Urinary Excretion ◽  
Head And Neck ◽  
Reference Range ◽  
Excretion Rate ◽  
Case Reports ◽  
Catecholamine Excess ◽  
Hydroxyindoleacetic Acid ◽  
Excretion Rates ◽  
Almost All ◽  
Head And Neck Paragangliomas

Background Case reports have documented carcinoid-like features in head and neck paragangliomas (HNPGLs), which, in addition to catecholamine storing granules, may also contain granules with serotonin. Serotonin is metabolized to 5-hydroxyindoleacetic acid (5-HIAA). Aim To assess the urinary excretion rates of 5-HIAA and catecholamines in HNPGL patients. Methods In 114 consecutive HNPGL patients, normetanephrine, metanephrine, norepinephrine, epinephrine, VMA, dopamine, 3-methoxytyramine and 5-HIAA excretion rates were measured in two 24-hour urinary samples. Increased excretion rates were defined as an increase of the average hormone excretion rate of 2 urine samples above the reference range. In all patients with catecholamine excess, intrathoracic and abdominal paragangliomas were excluded by 123I-MIBG scintigraphy, MRI and/or CT. Genetic screening for mutations in genes of the succinate dehydrogenase (SDH) family was performed. Results Mean urinary 5-HIAA excretion rate was 14±9 μmol/24 hours (reference range 10–44 μmol/24 hours). Urinary 5-HIAA excretion was slightly increased in only 1 patient (48 μmol/24 hours). None of the 50 patients (44%) with increased urinary excretion rates of catecholamines and/or their metabolites had elevated 5-HIAA excretion. Conclusion Urinary 5-HIAA excretion is within the normal reference range in almost all HNPGL patients. Therefore, this parameter has no clinical relevance in the routine clinical assessment of HNPGL patients.

scholarly journals Plasma levels of free metanephrines and 3-methoxytyramine indicate a higher number of biochemically active HNPGL than 24-h urinary excretion rates of catecholamines and metabolites

2013 ◽  
Vol 169 (3) ◽  
pp. 377-382 ◽  
Author(s):  
N van Duinen ◽  
E P M Corssmit ◽  
W H A de Jong ◽  
D Brookman ◽  
I P Kema ◽  
...  
Keyword(s):  
Urinary Excretion ◽  
Head And Neck ◽  
Plasma Levels ◽  
Vanillylmandelic Acid ◽  
Biochemical Activity ◽  
Catecholamine Excess ◽  
Number Of Patients ◽  
Excretion Rates ◽  
Head And Neck Paragangliomas

ContextA substantial number of patients with head and neck paragangliomas (HNPGLs) have biochemically active tumors, evidenced by increased urinary excretion of catecholamines and metabolites, including 3-methoxytyramine (3MT). It is unclear whether plasma levels of these parameters are more sensitive to detect biochemical activity in HNPGL patients than urinary excretion rates.ObjectiveTo compare plasma free levels vs urinary excretion rates of deconjugated 3MT and combined metanephrines (MNs) in patients with HNPGL.Patients and methodsWe included 124 consecutive patients with HNPGL for screening of catecholamine excess by measurement of 24-h urinary excretion rates of deconjugated (nor)metanephrine, (nor)epinephrine, dopamine, vanillylmandelic acid, 3MT, and plasma free levels of (nor)metanephrine and 3MT.ResultsPlasma free 3MT levels were increased in 35 of the 124 patients (28%), whereas 24-h urinary excretion of deconjugated 3MT was increased in 30 patients (24%) (P=0.13). Plasma free MN levels were increased in seven patients (6%) and urinary deconjugated MN levels in six patients (5%) (P=1.00). Plasma free normetanephrine (NMN) levels were increased in seven patients (6%), and five patients had increased urinary excretion of deconjugated NMN (4%) (P=0.69). Plasma free combined MN levels (NMN, MN, and 3MT) were increased in 41 patients (33%), whereas 24-h urinary excretion rates of deconjugated combined MNs were increased in 33 patients (27%, P<0.05).ConclusionsThe combined levels of free MNs and free 3MT in plasma indicate a higher number of biochemically active HNPGLs than the 24-h urinary excretion rates of these markers.

scholarly journals Urinary excretion of amino acids and their advanced glycation end-products (AGEs) in adult kidney transplant recipients with emphasis on lysine: furosine excretion is associated with cardiovascular and all-cause mortality

Amino Acids ◽  
2021 ◽  
Author(s):  
Svetlana Baskal ◽  
Adrian Post ◽  
Daan Kremer ◽  
Alexander Bollenbach ◽  
Stephan J. L. Bakker ◽  
...  
Keyword(s):  
Amino Acids ◽  
Urinary Excretion ◽  
Excretion Rate ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Advanced Glycation ◽  
Glycation End Products ◽  
End Products ◽  
All Cause Mortality ◽  
Excretion Rates

AbstractArginine (Arg) and lysine (Lys) moieties of proteins undergo various post-translational modifications (PTM) including enzymatic NG- and Nε-methylation and non-enzymatic NG- and Nε-glycation. In a large cohort of stable kidney transplant recipients (KTR, n = 686), high plasma and low urinary concentrations of asymmetric dimethylarginine (ADMA), an abundant PTM metabolite of Arg, were associated with cardiovascular and all-cause mortality. Thus, the prediction of the same biomarker regarding mortality may depend on the biological sample. In another large cohort of stable KTR (n = 555), higher plasma concentrations of Nε-carboxymethyl-lysine (CML) and Nε-carboxyethyl-lysine (CEL), two advanced glycation end-products (AGEs) of Lys, were associated with higher cardiovascular mortality. Yet, the associations of urinary AGEs with mortality are unknown. In the present study, we measured 24 h urinary excretion of Lys, CML, and furosine in 630 KTR and 41 healthy kidney donors before and after donation. Our result indicate that lower urinary CML and lower furosine excretion rates are associated with higher mortality in KTR, thus resembling the associations of ADMA. Lower furosine excretion rates were also associated with higher cardiovascular mortality. The 24 h urinary excretion rate of amino acids and their metabolites decreased post-donation (varying as little as − 24% for CEL, and as much as − 62% for ADMA). For most amino acids, the excretion rate was lower in KTR than in donors pre-donation [except for S-(1-carboxyethyl)-l-cysteine (CEC) and NG-carboxyethylarginine (CEA)]. Simultaneous GC–MS measurement of free amino acids, their PTM metabolites and AGEs in urine is a non-invasive approach in kidney transplantation.

Effects of thyroparathyroidectomy, parathyroid hormone, and PTHrP on kidneys of ovine fetuses

1993 ◽  
Vol 264 (1) ◽  
pp. E37-E44 ◽  
Author(s):  
R. J. MacIsaac ◽  
R. S. Horne ◽  
I. W. Caple ◽  
T. J. Martin ◽  
E. M. Wintour
Keyword(s):  
Parathyroid Hormone ◽  
Urinary Excretion ◽  
Excretion Rate ◽  
Plasma Concentrations ◽  
Free Water ◽  
Total Calcium ◽  
Fetal Plasma ◽  
Parathyroid Hormone Related Protein ◽  
Fetal Urine ◽  
Excretion Rates

The fetal parathyroid glands and parathyroid hormone-related protein (PTHrP) have been shown to be important regulators of fetal calcium metabolism through their actions on the placenta and bone. This study examined the effects of fetal thyroparathyroidectomy (with thyroxine replacement) and exogenous infusion of human parathyroid hormone [PTH-(1–34)], PTHrP-(1–34), and PTHrP-(1–141) on the urinary excretion of calcium in chronically cannulated ovine fetuses during the last one-fifth of gestation. Fetal plasma total and ionized calcium concentrations were significantly lower in thyroparathyroidectomized (TxPTx) fetuses when compared with intact fetuses, but there were no significant differences in urinary excretion rates of total calcium. However, TxPTx produced a significant increase in the fractional excretion rate of total calcium and a significant decrease in the excretion of adenosine 3',5'-cyclic monophosphate (cAMP) compared with intact fetuses. Infusions of PTH-(1–34), PTHrP-(1–34), and PTHrP-(1–141) into the jugular vein of TxPTx fetuses (n = 5) at the rate of 1 nmol/h for 2 h, after a 1-nmol loading dose, significantly decreased the excretion rate of total calcium and increased the excretion rate of cAMP in fetal urine. Infusions of all three peptides resulted in significant increases in the concentration of total calcium in fetal plasma but had no effect on the plasma concentrations or urinary excretion rates of phosphate. Infusion of either PTH-(1–34), PTHrP-(1–34), or PTHrP-(1–141) also resulted in an increase in fetal urine osmolality and pH and a decrease in free water clearance in TxPTx fetuses.(ABSTRACT TRUNCATED AT 250 WORDS)

Increased urinary excretion of digoxin-like immunoreactive substance by insulin-dependent diabetic patients: a linkage with hypertension?

1988 ◽  
Vol 34 (12) ◽  
pp. 2418-2422 ◽  
Author(s):  
O Giampietro ◽  
A Clerico ◽  
G Gregori ◽  
S Bertoli ◽  
M G Del Chicca ◽  
...  
Keyword(s):  
Body Weight ◽  
Urinary Excretion ◽  
Body Mass ◽  
Cardiac Glycoside ◽  
Excretion Rate ◽  
Diabetic Patients ◽  
Insulin Dependent ◽  
The Mean ◽  
Excretion Rates ◽  
Insulin Dependent Diabetic

Abstract Excretion of digoxin-like immunoreactivity (DLIS) was measured by RIA in timed overnight urine collections from 91 normotensive nondiabetic subjects and 104 normotensive insulin-dependent diabetic (IDDM) patients. The mean +/- SD DLIS excretion rate for the diabetic patients significantly exceeded that for the controls (73 +/- 41 vs 63 +/- 36 pg/min, P = 0.024). In both groups, the mean DLIS excretion rates for men were significantly higher (P = 0.0014, P = 0.006) than for women. In the controls, the DLIS excretion rate significantly correlated with the urinary excretion rate of creatinine (P less than 0.01), Na+ (P less than 0.05), and K+(P less than 0.05), and with the subjects' body weight (P less than 0.01), body mass index (P less than 0.05), and systolic blood pressure (P less than 0.05). In the diabetics, the DLIS excretion rate was significantly correlated with body weight (P less than 0.05) and with urinary excretion rates for albumin (P less than 0.01), creatinine (P less than 0.01), Na+ (P less than 0.05), and K+(P less than 0.05). Our data indicate that: (a) increased amounts of a cardiac glycoside-like substance (or a group of substances) are excreted in the urine of IDDM patients; (b) the urinary excretion of DLIS seems to depend on glomerular filtration rate and physiocochemical properties of glomerular membrane, as well as on subjects' body mass; and (c) because cardiac glycoside-like substances may increase peripheral vascular resistance, increased urinary excretion of DLIS by IDDM patients may indicate a tendency to develop hypertension.

scholarly journals Herbal medicines for urinary stone treatment. A systematic review

2016 ◽  
Vol 88 (1) ◽  
pp. 38 ◽  
Author(s):  
Elena Monti ◽  
Alberto Trinchieri ◽  
Vittorio Magri ◽  
Anne Cleves ◽  
Gianpaolo Perletti
Keyword(s):  
Urinary Tract ◽  
Urinary Excretion ◽  
Excretion Rate ◽  
Meta Analysis ◽  
Urinary Calcium ◽  
Mean Difference ◽  
Urinary Excretion Rate ◽  
Stone Size ◽  
Excretion Rates

Objective: To analyze the clinical evidence on the efficacy of phytotherapy in the treatment of calculi in the urinary tract. Methods: To be eligible, full-length articles should include the results of randomized controlled trials enrolling patients affected by urolithiasis, reporting any comparison between an experimental herbal agent versus placebo or any active comparator, aimed at preventing the formation or facilitating the dissolution of calculi in any portion of the urinary tract. Fifteen databases were searched for relevant references. The primary outcomes investigated were (i) the reduction of stone size and/or number and (ii) the urinary excretion rates of calcium, urate, or oxalate. The secondary outcome of the review was the adverse effects (AE) of treatment. Risk of bias (ROB) and quality of the evidence were assessed according to Cochrane and GRADE guidelines. We performed a randomeffect meta-analysis. Results: 541 articles were retrieved and 16 studies were finally confirmed as eligible. Multiple Cochrane ROB tool items were rated as having high risk of bias in each analyzed trial report. Pooled analysis of continuous data could be performed for three different comparisons: (i) phytotherapy versus citrate as single agent (ii) phytotherapy versus placebo, (iii) preparation of Didymocarpus pedicellata (DP) -combined with other herbal agents- versus placebo. Results showed that citrate is superior to phytotherapy in significantly decreasing both the size of urinary stones (mean difference: phytotherapy, 0.42 mm higher; 95% CI: 0.23 to 0.6; Z = 4.42, P &lt; 0.0001; I<sup>2</sup> = 30%) and the urinary excretion rate of urate (mean difference: 42.32 mg/24h higher, 95% CI: 19.44 to 65.19; Z = 3.63, P = 0.0003; I<sup>2</sup> = 96%), assessed after 3 months on-therapy. No significant differences in the excretion rates of urinary calcium or oxalate were found. The DP preparation was superior to placebo in inducing total clearance (risk ratio: 6.19, 95% CI: 2.60 to 14.74; Z = 4.12, P &lt; 0.0001; I<sup>2</sup> = 0%) and size reduction (mean difference: DP preparation, 4.93 mm lower; 95% CI: -9.18 to -0.67; Z = 2.27, P = 0.02; I<sup>2</sup> = 99%) of renal and ureteral stones after 3 months of therapy. No significant differences in the inter-arm variation of excretion rates of urinary calcium or urate were found as result of the pooled phytotherapy- placebo comparison. Herbal remedies were in general devoid of side effects and in few cases citrate appeared to induce GI disturbances in a higher fraction of patients. Most reports did not provide inferential data concerning AE, and meta-analysis was not feasible. Conclusions: Citrate is more effective than phytotherapy in decreasing the size of existing calculi in the urinary tract and in decreasing the urinary excretion rate of uric acid. A preparation containing Didymocarpus pedicellata combined with other herbal agents induces stone size reduction and clearance significantly better than placebo. Mayor limitations in the applicability of these results are the low quality of the evidence and the multiple sources of bias assessed in the studies included in the present review.

scholarly journals Increased prevalence of catecholamine excess and phaeochromocytomas in a well-defined Dutch population with SDHD-linked head and neck paragangliomas

2005 ◽  
Vol 152 (1) ◽  
pp. 87-94 ◽  
Author(s):  
W H van Houtum ◽  
E P M Corssmit ◽  
P B Douwes Dekker ◽  
J C Jansen ◽  
A G L van der Mey ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Head And Neck ◽  
Histopathological Examination ◽  
Positive Family History ◽  
Mibg Scintigraphy ◽  
Resonance Imaging ◽  
Catecholamine Excess ◽  
Head And Neck Paragangliomas

Objective: The aim of this study was to identify the prevalence of catecholamine excess and phaeochromocytomas in a well-defined population of people with hereditary head and neck paragangliomas. Methods: We studied in a prospective follow-up protocol all consecutive patients referred to the Department of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands with documented head and neck paragangliomas and either a positive family history for paragangliomas or a proven SDHD gene mutation. Initial analysis included medical history, physical examination and the measurement of excretion of catecholamines in two 24-h urine collections. In the case of documented catecholamine excess iodinated meta-iodobenzylguanidine (123I-MIBG) scintigraphy and magnetic resonance imaging were done. Results: Between 1988 and 2003, 40 consecutive patients (20 male and 20 female) with documented head and neck paragangliomas were screened. Biochemical screening revealed urinary catechol-amine excess in 15 patients (37.5%). In nine of these 15 patients a lesion was found by 123I-MIBG scintigraphy. Exact localization by magnetic resonance imaging revealed phaeochromocytomas in seven of the 15 patients. One of the nine patients had an extra-adrenal paraganglioma. Histopathological examination in a subset of tumors displayed loss of heterozygosity of the wild-type SDHD allele in all cases. Conclusions: The prevalence of catecholamine excess (37.5%) and phaeochromocytomas (20.0%) is high in patients with familial head and neck paragangliomas. Therefore, patients with hereditary head and neck paragangliomas require lifelong follow up by biochemical testing for catecholamine excess.

A Radioimmunoassay for Human Urinary Prealbumin

1993 ◽  
Vol 30 (4) ◽  
pp. 377-382 ◽  
Author(s):  
R Beetham ◽  
A Dawnay ◽  
C Ghany ◽  
S Dubrey ◽  
J Miles
Keyword(s):  
Urinary Excretion ◽  
Room Temperature ◽  
Reference Range ◽  
Excretion Rate ◽  
Urine Samples ◽  
Creatinine Excretion ◽  
Normal Reference Range ◽  
Normal Reference ◽  
Significant Difference ◽  
Highly Correlated

We describe a validated radioimmunoassay for prealbumin in urine. Using timed overnight urine samples, the normal reference range was less than 10–148μg/L; or less than 1·8–9·6μg/mmol creatinine, excretion in women being significantly greater than in men ( P<0–05); or less than 7–3–114 ng/min with no significant difference in excretion rate between the sexes. Urines exhibited loss of immunoreactivity after storage at — 20°C and thawing. No such loss occurred after storage for 4 weeks at 4°C or room temperature. The urinary excretion of prealbumin was highly correlated with that of albumin ( r = 0·85), and clearance relative to creatinine was 2 × 10−6, the same order as that of albumin.

scholarly journals Urinary Dimethylamine (DMA) and Its Precursor Asymmetric Dimethylarginine (ADMA) in Clinical Medicine, in the Context of Nitric Oxide (NO) and Beyond

2020 ◽  
Vol 9 (6) ◽  
pp. 1843 ◽  
Author(s):  
Dimitrios Tsikas
Keyword(s):  
Rheumatoid Arthritis ◽  
Nitric Oxide ◽  
Urinary Excretion ◽  
Children And Adolescents ◽  
Asymmetric Dimethylarginine ◽  
Excretion Rate ◽  
Whole Body ◽  
Elderly Subjects ◽  
Muscular Disease ◽  
Excretion Rates

Asymmetric protein-arginine dimethylation is a major post-translational modification (PTM) catalyzed by protein-arginine methyltransferase (PRMT). Regular proteolysis releases asymmetric dimethylarginine (ADMA). Of the daily produced ADMA, about 10% are excreted unchanged in the urine. The remaining 90% are hydrolyzed by dimethylarginine dimethylaminohydrolase (DDAH) to L-citrulline and dimethylamine (DMA), which is readily excreted in the urine. The PRMT/DDAH pathway is almost the exclusive origin of urinary ADMA and the major source of urinary DMA. Dietary fish and seafood represent additional abundant sources of urinary DMA. The present article provides an overview of urinary ADMA and DMA reported thus far in epidemiological, clinical and pharmacological studies, in connection with the L-arginine/nitric oxide (NO) pathway and beyond, in neonates, children and adolescents, young and elderly subjects, males and females. Discussed diseases mainly include those relating to the renal and cardiovascular systems such as peripheral arterial occlusive disease, coronary artery disease, chronic kidney disease, rheumatoid arthritis, Becker muscular disease, Duchenne muscular disease (DMD), attention deficit hyperactivity disorder (ADHD), and type I diabetes. Under standardized conditions involving the abstinence of DMA-rich fresh and canned fish and seafood, urinary DMA and ADMA are useful as measures of whole-body asymmetric arginine-dimethylation in health and disease. The creatinine-corrected excretion rates of DMA range from 10 to 80 µmol/mmol in adults and up to 400 µmol/mmol in children and adolescents. The creatinine-corrected excretion rates of ADMA are on average 10 times lower. In general, diseases are associated with higher urinary DMA and ADMA excretion rates, and pharmacological treatment, such as with steroids and creatine (in DMD), decreases their excretion rates, which may be accompanied by a decreased urinary excretion of nitrate, the major metabolite of NO. In healthy subjects and in rheumatoid arthritis patients, the urinary excretion rate of DMA correlates positively with the excretion rate of dihydroxyphenylglycol (DHPG), the major urinary catecholamines metabolite, suggesting a potential interplay in the PRMT/DDAH/NO pathway.

scholarly journals Increased Urinary Excretion of 3-Methoxytyramine in Patients with Head and Neck Paragangliomas

2010 ◽  
Vol 95 (1) ◽  
pp. 209-214 ◽  
Author(s):  
N. van Duinen ◽  
D. Steenvoorden ◽  
I. P. Kema ◽  
J. C. Jansen ◽  
A. H. J. T. Vriends ◽  
...  
Keyword(s):  
Urinary Excretion ◽  
Head And Neck ◽  
Head And Neck Paragangliomas

scholarly journals Excretion of digoxin-like immunoreactivity in urine of normal subjects: correlations with excretion of creatinine and electrolytes.

1988 ◽  
Vol 34 (3) ◽  
pp. 554-556 ◽  
Author(s):  
A Clerico ◽  
O Giampietro ◽  
G Gregori ◽  
M G Del Chicca ◽  
S Bertoli ◽  
...  
Keyword(s):  
Urinary Excretion ◽  
Excretion Rate ◽  
Normal Subjects ◽  
Urine Samples ◽  
Urinary Excretion Rate ◽  
The Mean ◽  
Positive Correlations ◽  
Excretion Rates ◽  
Sodium And Potassium ◽  
Normal Adults

Abstract To verify whether there is a variation in the 24-h urinary excretion of digoxin-like immunoreactivity (DLIS) in humans, we studied 18 normal adults, who collected their urines for 24-h in several portions. We then measured DLIS (by means of a sensitive RIA method), creatinine, sodium, and potassium concentrations in the urine samples. The mean urinary excretion rate for DLIS in the complete 24-h collection was 84.8 (SD 31.3) pg/min. The mean DLIS urinary excretion rate calculated for overnight collections was significantly lower than those of afternoon collections (P less than 0.01) and the 24-h collection (P less than 0.05). Significant positive correlations were found between urinary DLIS and excretion rates for creatinine (r = 0.347, P = 0.0016), Na+ (r = 0.232, P = 0.038), and K+ (r = 0.323, P = 0.003), respectively. Our data suggest that urinary excretion of DLIS is higher during "active" hours of the day, especially in the afternoon, than at rest, during the night.

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