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Catecholamine and metanephrine excess in intracerebral haemorrhage: revisiting an obscure yet common “pseudophaeochromocytoma”
  1. Melvin Khee Shing Leow1,
  2. Keh Chuan Loh1,
  3. Tong Kiat Kwek2,
  4. Puay Yong Ng3
  1. 1Division of Medicine, Department of Endocrinology, Tan Tock Seng Hospital, Singapore, Singapore
  2. 2Division of Surgery, Department of Anaesthesia, Tan Tock Seng Hospital, Singapore, Singapore
  3. 3Division of Surgery, Department of Neurosurgery, National Neuroscience Institute, Singapore, Singapore
  1. Correspondence to:
 Dr M K S Leow
 Division of Medicine, Department of Endocrinology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore; mleowsj{at}

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We prospectively recruited five patients with CT evidence of intracerebral haemorrhage (ICH), having excluded trauma, a history of phaeochromocytoma (PHEO) and sympathomimetics/antihypertensives capable of increasing catecholamines (CATS)/metanephrines (METS). Informed consent was obtained from the next of kin. Plasma METS are superior to plasma CATS, although both are unavailable locally. Urinary CATS/METS, which integrate CATS/METS secretion and has greater sensitivity than plasma CATS in the absence of PHEO spells, was used.1 24 h urinary CATS/METS were sampled on days 1 and 7 and before discharge. Catheterised urine was transferred into bottles containing 10 ml 6 N HCl, and analysed by high-performance liquid chromatography (HPLC)–electrochemical detection. Patients with increases in CATS/METS underwent abdominal CT. ICH volume was estimated from CT. This research was ethically approved …

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  • Competing interests: None.