Urine catecholamine levels as diagnostic markers for neuroblastoma in a defined population: Implications for ophthalmic practice

S. J. Smith, N. N. Diehl, B. D. Smith, B. G. Mohney

Research output: Contribution to journalArticlepeer-review

22 Scopus citations

Abstract

Purpose: Although elevated urinary catecholamine levels have been reported in 90-95% of patients with neuroblastoma, more recent studies of pediatric Horner syndrome caused by an underling neuroblastoma have reported normal values at presentation. The purpose of this population-based study is to report the percentage of cases of neuroblastoma with elevated urinary catecholamine levels at presentation and to suggest a recommended work-up for cases of idiopathic pediatric Horner syndrome. Methods: The medical records of all pediatric (< 19 years) residents of Olmsted County, Minnesota diagnosed with neuroblastoma from 1 January 1969 through 31 December 2008 were retrospectively reviewed. Results: A total of 14 patients < 19 years of age were diagnosed with neuroblastoma as residents of Olmsted County, Minnesota, during the 40-year study period. A total of 10 (71%) of the 14 cases manifested elevated urinary catecholamine metabolites at the initial presentation. Urinary vanillylmandelic acid (VMA) levels were greater than twice the upper limit of normal in eight (57%) of 14 cases, whereas homovanillic acid (HVA) levels were greater than two times the upper limit of normal in 10 (71%) of the 14 cases. Three (75%) of the four cases without significantly elevated urinary VMA or HVA levels were diagnosed with stage IV disease, whereas one (25%) had stage II neuroblastoma. Conclusion: Urinary catecholamine levels were significantly elevated at presentation in 10 (71%) of the 14 neuroblastoma cases during the 40-year study period, suggesting that greater emphasis be placed on performing a thorough physical examination and obtaining warranted imaging studies in cases of idiopathic pediatric Horner syndrome.

Original languageEnglish (US)
Pages (from-to)1792-1796
Number of pages5
JournalEye
Volume24
Issue number12
DOIs
StatePublished - Dec 2010

Keywords

  • HVA
  • Horner syndrome
  • VMA
  • catecholamine
  • neuroblastoma

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems

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