Endocrine Abstracts

Objectives: The audit was carried out to inform the development of a local protocol for investigation of patients with suspected sporadic phaeochromocytoma.

Method: Details of all UCAT tests performed in 2006 for a catchment area of approximately 500 000 were obtained.

Questionnaires were used to obtain further information about all the patients referred from primary care and secondary care patients with UCAT > upper limit of normal (ULN).

Results: About 250 requests from primary care (159 patients) and 620 requests from secondary care (425 patients) were identified.

The median age of the patients was 48 years, range 1–88 years, 9.7% > 70 years.

The results of 17.2% of primary care and 19% of secondary care requests were abnormal. The majority of abnormal results were < twice the ULN. Only 1.4% of all results were > twice the ULN.

Of the 5 confirmed cases of phaeochromocytoma/paraganglioma, 3 had UCAT results > twice the ULN.

No symptom or symptom cluster predicted abnormal UCAT results.

About 99 patients had two and 114 had three UCAT tests requested at same time: 93.4% of these had a consistent pattern of results.

About 36% of primary care patients and 50% of secondary care patients were prescribed medication that could cause false positive UCAT results.

Conclusions: One hundred and four UCAT tests were carried out per 1 confirmed case. Slightly elevated UCAT results (<2× ULN) were common and not necessarily indicative of phaeochromocytoma. In an unselected patient population, classic symptoms of phaeochromocytoma were non-specific and did not help to predict results. Routine requests for multiple ‘cold’ UCAT tests are probably not necessary, though repeat testing after a symptomatic episode is indicated for patients where the clinical suspicion is high.

The effect of medication should be taken into consideration when interpreting slightly elevated UCAT results.