Urine of Children with Sympathetic Tumors

Abstract

Armstrong and co-workers¹ found, in 1956, while investigating the phenolic acids, a previously unknown constituent of human urine, which they identified one year later as 3-methoxy-4-hydroxymandelic acid (MHMA, vanillylmandelic acid).^2,3 At the same time they proved that the substance was a metabolite of norepinephrine. Shortly after this, several authors^4-13 published further work on the metabolism of epinephrine and norepinephrine which confirmed the fact that MHMA was the chief breakdown product. This is shown in Figure 1. Contrary to the labile catecholamines, this methylated pyrocatechinic acid is stabile. About 70 times as much appears in the urine as in the catecholamines.¹⁴ This simplifies its quantitative determination. As the MHMA is excreted largely independently of nutritive factors,³ it represents a measure of the turnover of the catecholamines. For this reason, its quantitative determination is of great theoretical and practical significance. During the test period, bananas should be