Catecholamines is a collective term for the hormones epinephrine, norepinephrine, and dopamine. Manufactured chiefly by the chromaffin cells of the adrenal glands, these hormones are involved in readying the body for the "fight-or-flight" response (also known as the alarm reaction). When these hormones are released, the heart beats stronger and faster, blood pressure rises, more blood flows to the brain and muscles, the liver releases stores of energy as a sugar the body can readily use (glucose), the rate of breathing increases and airways widen, and digestive activity slows. These reactions direct more oxygen and fuel to the organs most active in responding to stress—mainly the brain, heart, and skeletal muscles.
Pheochromocytoma (a tumor of the chromaffin cells of the adrenal gland) and tumors of the nervous system (neuroblastomas, ganglioneuroblastomas, and ganglioneuromas) that affect hormone production can cause excessive levels of different catecholamines to be secreted. This results in constant or intermittent high blood pressure (hypertension). Episodes of high blood pressure may be accompanied by symptoms such as headache, sweating, palpitations, and anxiety. The catecholamines test can be ordered, then, to determine if high blood pressure and other symptoms are related to improper hormone secretion and to identify the type of tumor causing elevated catecholamine levels.
The catecholamines test can be performed on either blood or urine. If performed on blood, the test may require one or two samples, depending on the physician's request. The first blood sample will be drawn after the patient has been lying down in a warm, comfortable environment for at least 30 minutes. If a second sample is needed, the patient will be asked to stand for 10 minutes before the blood is drawn. Instead of a venipuncture, which can be stressful for the patient, possibly increasing catecholamine levels in the blood, a plastic or rubber tube-like device called a catheter may be used to collect the blood samples. The catheter would be inserted in a vein 24 hours in advance, eliminating the need for needle punctures at the time of the test.
It may take up to a week for a lab to complete testing of the samples. Because blood levels of catecholamines commonly go up and down in response to such factors as temperature, stress, postural change, diet, smoking, obesity, and many drugs, abnormally high blood test results should be confirmed with a 24-hour urine test. In addition, catecholamine secretion from a tumor may not be steady, but may occur periodically during the day, and potentially could be missed when blood testing is used. The urine test provides the laboratory with a specimen that reflects catecholamine production over an entire 24-hour period. If urine is tested, the patient or a healthcare worker must collect all the urine passed over the 24-hour period.
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Author Info: Janis O. Flores, The Gale Group Inc., Gale, Detroit, Gale Encyclopedia of Medicine, 2002 |