Simultaneous Urinary Assays for the Combined Metanephrines and 3-Methoxy-4-Hydroxyphenylglycol in Patients with Pheochromocytoma and Primary Hypertension

THE discovery, by Armstrong and McMillan,1 in 1957, of the presence of the catecholamine metabolite, 3-methoxy-4-hydroxymandelic acid (VMA), in human urine stimulated investigations that resulted in the identification of other urinary catecholamine metabolites, the quantitative determinations of their relative urinary excretions and the employment of these urinary catecholamine metabolite assays in the diagnosis of pheochromocytoma and other catecholamine-secreting tumors.2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 Technics for the quantitative urinary determination of VMA employing a variety of analytic procedures have been described, and the increased excretion of this metabolite in patients with pheochromocytomas has been emphasized.2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Axelrod and other investigators subsequently demonstrated that epinephrine (E) and . . .