From the Research
A metanephrine level of 238 is generally considered elevated and warrants further evaluation. The normal range for plasma metanephrine typically falls between 0-180 pg/mL (or 0-0.9 nmol/L), though reference ranges can vary slightly between laboratories 1. Without knowing the units of measurement (pg/mL, nmol/L) and whether this is a plasma or urine test, I can only provide a general assessment. If this is a 24-hour urine collection, normal ranges are different and typically higher. Metanephrine is a metabolite of epinephrine (adrenaline) and is measured to help diagnose conditions like pheochromocytoma or paraganglioma, which are rare tumors that produce excess catecholamines. Slightly elevated levels may occur due to stress, certain medications (including some antidepressants, decongestants, and stimulants), caffeine consumption, or physical activity before the test.
Key Considerations
- The diagnosis of pheochromocytoma is typically made based on elevated levels of plasma or urinary metanephrines, with a sensitivity of 100% for plasma metanephrines 1.
- A clonidine-suppression test can be used to distinguish between true- and false-positive results, with a high specificity for pheochromocytoma 2.
- Patients with borderline-elevated urine or plasma metanephrine levels may require further diagnostic testing, including imaging studies and genetic testing 3.
- The treatment of pheochromocytoma typically involves surgical removal of the tumor, with preoperative preparation using alpha-blockers and/or beta-blockers to minimize the risk of complications 4.
Recommendations
- If the metanephrine level is elevated, further evaluation is necessary to determine the cause and to rule out pheochromocytoma or other conditions.
- A healthcare provider should interpret the result in the context of the patient's specific clinical situation and testing conditions.
- Additional testing, such as imaging studies and genetic testing, may be necessary to confirm the diagnosis and guide treatment.