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What is V.M.A levels are elevated in all except? and explain in detail?
Vanillylmandelicacid,urine(VMA) <15mg/gcreatinine Catecholaminesaresecretedin excessbypheochromocytomasand otherneuralcresttumors,andare metabolizedbytheenzymes monoamineoxidaseandcatechol-OmethyltransferasetoVMA,whichis excretedinurine. Increasedin:Pheochromocytoma (64%sensitivity,95%specificity), neuroblastoma,ganglioneuroma, generalizedanxiety. Decreasedin:Drugs:monoamine oxidaseinhibitors(MAOIs),eg, phenelzine. Elevated VMA level is suggestive of pheochromocytoma, but is not diagnostic. A normal VMA level does not rule out pheochromocytoma. Test is usually ordered along with homovanillic acid (HVA) on random urine sample for screening children for catecholamine-secreting tumors (eg, neuroblastoma) and other neural crest tumors, and for monitoring patients who have had treatment for these tumors.