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Pacak Lab: Section on Medical Neuroendocrinology

Developmental Endocrine Oncology and Genetics

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Get the latest research information from NIH: https://www.covid19.nih.gov | Español
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Karel Pacak, MD, PhD, DSc

karel pacak

Phone: 301-402-4594

Email: karel@mail.nih.gov

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Bethesda, MD 20892

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Diagnostic Tests

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  • Created by Sahar Hossini, last modified by Unknown User (knuemm) on Apr 15, 2020
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You may undergo blood and imaging studies during your evaluation at NIH. Not all studies will be performed and will be individually determined.

Biochemistry/Blood Tests

When coming to the NIH you will be required to have your blood drawn for diagnostic and research purposes. A plastic catheter/IV may be placed placed in your arm and you will be asked to lie still in a dark room for 30 minutes prior to the blood draw.

Preparation for Biochemical Diagnosis

Blood for biochemical and genetic diagnosis may be taken.

Factors that may influence biochemical diagnosis:

  • Physical stress (or exercise) or illness (e.g. stroke, myocardial infarction, congestive heart failure, obstructive sleep apnea)
  • Certain drugs (tricyclic antidepressants, levodopa, decongestants, amphetamines, buspirone and most psychoactive agents, prochlorperazine, reserpine, withdrawal from clonidine  and acetaminophen)
  • Caffeine, nicotine and alcohol

Catecholamine and Metanephrine Testing (also known as resting labs)

This testing is performed to assess the levels of catecholamines and metanephrines in the blood. Catecholamines and metanephrines are often secreted by pheochromocytoma and paraganglioma cells and are the cause of most pheochromocytoma/paraganglioma symptoms.

At the NIH, an indwelling catheter (also known as an IV) will be placed in the patient's arm. The patient will then be asked to rest, lying flat on his or her back with no pillow, in a dark room for 30 minutes prior to the blood draw. The blood is assessed at the NIH laboratory and  results are received within 2 weeks.

24 hour urine may also be collected.  For the duration of your 24 hour urine, please continue to follow all the food and medication restrictions.





Imaging Tests

*Please let us know if you have any metal implants or a pacemaker as these may interfere with certain imaging tests

*All metal jewelry, piercings, belts, etc., need to be removed prior to any scanning*

*If you are claustrophobic please let us know in advance. We have medication available that will relax the body, allowing you to undergo the needed scans.*

A technician assisting a patient receiving a CT scan

Imaging tests are used to assess the location of a pheochromocytoma or paraganglioma. For some of the imaging studies,, it is the requirement of the radiology department that within seven days of any imaging studies (scan) you will be required to have your blood drawn. This is to ensure that your kidneys are functioning well enough to filter the contrast dyes from the scans.

Magnetic Resonance Imaging (MRI)

Computed Tomography (CT) Scan

Fluorodopamine (FDA) PET Imaging (Research Scan)

Fluorodopa (FDOPA) PET Imaging (Research Scan)

Fluorodeoxyglucose (FDG) PET/CT Imaging

Gallium-68 Dotatate PET/CT Scan (Research scan)

I-123 Meta-Iodobenzylguanidine Scintiscan (MIBG)



Genetic Testing

The protocol  can provide genetic testing for patients and family members affected with pheochromocytoma.

Please refer to our Genetic Screening page for more information regarding genetic testing.

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