Paracetamol-associated interference in an HPLC-ECD assay for urinary free metadrenalines and catecholamines

Ann Clin Biochem 2004;41:316-320
doi:10.1258/0004563041201626
© 2004 Royal Society of Medicine

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Original Articles


Fraser D Davidson


Biochemistry Department, Crosshouse Hospital, Kilmarnock KA2 0BE, UK


Background: Some high-performance liquid chromatography techniqueswith electrochemical detection for urinary catecholamines andtheir metabolites can be subject to interference from drugsand their metabolites. Prime amongst these interferences arethose due to paracetamol ingestion.

Methods: The prevalence of paracetamol contamination was determinedby measuring the drug in all patient specimens submitted forcatecholamine analysis over a 2-month period. These findingswere then related to the proportion of unreportable resultsat each range of specimen paracetamol concentration. The apparentresults from a small representative sample of the paracetamol-positivespecimens are illustrated.

Results: Approximately one-third of urine specimens were foundto contain paracetamol. Low-level contamination can produceapparent patterns of results which may easily be confused withthose found in predominantly adrenaline-, or metadrenaline-secretingphaeochromocytomas.

Conclusion: Despite the fact that significantly less than 5%of an oral dose of paracetamol is excreted as the free drug,its analysis provides a good surrogate marker for the likelihoodof spurious results. It is useful to know prior to urinary freemetadrenaline or catecholamine analysis which urine specimensare likely to contain potentially interfering paracetamol metabolites.


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