[Normal values of plasma methoxyamines in the setting of renal insufficiency and peri-operative stress. Consequences for the etiological diagnosis of hypertension].
BACKGROUND
HPLC plasma methoxyamines measurements are the updated technique for the diagnosis of adrenergic hypersecretion. Their reliability meets that of urinary measurements. Significance of increased values is not yet fully established for the etiological diagnosis of hypertension in some situations, especially in case of renal insufficiency and in the peri-operative period. The aim of this study is to define the "normal" range of the values of plasma methoxyamines in both of those conditions.


METHODS
in a General and Endocrine Surgical Unit, 3 homogeneous group of 20 patients each have been studied: group 1, control (patients awaiting thyroidectomy); group 2, patients on maintenance hemodialysis submitted for hyperparathyroidism; group 3, patients submitted to digestive surgery. Measurements were done pre-operatively in group 1, pre and post-operatively in group 2, and post-operatively in group 3.


RESULTS
in comparison to the control (11.8 nmol/l), we observed in group 2 a 18 fold increase preoperatively, and a 29 fold increase at post-operative day 1. In group 3, we observed a 2.3, 2.7 and 2 fold increase at post-operative days 1,2 and 3 respectively. All those results were statistically significant.


CONCLUSIONS
Results of measurements of plama methoxyamines should always be matched to the serum creatinine levels. They are meaningful for the diagnosis of endocrine origin of hypertension only late after the early post-operative period.
Mulliez
E
E
Clinique Chirurgicale Est, Service de Chirurgie Générale et Endocrinienne. Hôpital Huriez CHRU de Lille, rue Michel-Polonovski, 59037 Lille cedex, France.
Rouaix-Emery
N
N
Pisanu
A
A
Wémeau
J L
JL
Proye
C
C
D002851:Chromatography, High Pressure Liquid; D013505:Digestive System Surgical Procedures; D006801:Humans; D006898:Hydroxylamines / Q000097:blood*; D006961:Hyperparathyroidism / Q000097:blood; D006973:Hypertension / Q000175:diagnosis* / Q000209:etiology*; D012016:Reference Values; D006435:Renal Dialysis; D051437:Renal Insufficiency / Q000097:blood*; D012680:Sensitivity and Specificity; D013312:Stress, Physiological / Q000097:blood* / Q000209:etiology; D013514:Surgical Procedures, Operative / Q000009:adverse effects*; D013965:Thyroidectomy
D006898:Hydroxylamines; C005214:methoxyamine