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Catecholamines, Urine 24-Hour

VMA

Test Codes

EPIC: LAB1231354, Beaker: XCT24, WARDE: UCATE

Department

Send Outs

Instructions

If a random sample for Catecholamines, Urine is requested, please see Catecholamines, Urine Random.

Specimen Collection Criteria

Collect: 24-hour urine sample with 25 mL of 6N Hydrochloric Acid added prior to the start of collection.

• Keep 24-hour urine specimen iced or refrigerated during collection.
• Include start and end dates and times for the collection period on the specimen container.

Urine Preservative Options
No Preservative	6N Hydrochloric Acid	Boric Acid (10g)	Sodium Carbonate	50% Acetic Acid
Unacceptable	Required	Unacceptable	Unacceptable	Unacceptable

Physician Office/Draw Specimen Preparation

Maintain specimens refrigerated (2-8°C or 36-46°F) prior to transport.

Preparation for Courier Transport

Transport: Entire 24-hour urine collection refrigerated (2-8°C or 36-46°F).

Rejection Criteria

• Samples not kept refrigerated (2-8°C or 36-46°F).
• Specimens not collected and processed as indicated.

In-Lab Processing

Measure total volume of 24-hour urine specimen. Record total volume and collection start and end dates and times in the LIS system. Aliquot 25.0 mL from the well-mixed 24-hour urine collection (Minimum: 10.0 mL). The pH of 24-hour urine collection with added preservative should be between 1.0 and 3.0. (minimum volume: 10.0 mL)

Storage

Specimen Stability for Testing:

Room Temperature (20-26°C or 68-78.8°F): 72 hours
Refrigerated (2-8°C or 36-46°F): 7 days
Frozen (-20°C/-4°F or below): 1 month

Specimen Storage in Department Prior to Disposal:

Specimen retention time is determined by the policy of the reference laboratory. Contact the Send Outs Laboratory with any questions.

Laboratory

Sent to Warde Medical Laboratory, Ann Arbor, MI.

Performed

Monday – Friday.
Results are available in 1-4 days.

Reference Range

By report.

Test Methodology

High-Performance Liquid Chromatography (HPLC).

Interpretation

Levels of epinephrine (E) and norepinephrine (NE) as well as their metabolites, the metanephrines and VMA, will be increased in cases of pheochromocytoma (NE usually significantly higher than E). If E is the predominant abnormality, it suggests the adrenal medulla is the site of the tumor. If NE is predominant, the tumor is more likely to be outside the adrenal gland.

Levels of NE, dopamine (D), and their metabolites, may be increased in neuroblastoma, ganglioneuroblastoma, ganglioneuroma and paragangliomas, but not as predictably as in pheochromocytoma. Elevations are also seen in myocardial infarction, hypothyroidism, diabetic acidosis and manic depressive disorders of long duration.

Catecholamines may also be increased due to exercise, stress, smoking and pain.

Very high levels of alpha-methyldopamine may interfere with measurement of the internal standard.

Isoproterenol and Isoetharine (synthetic amines) used in the treatment of bronchial asthma and related conditions can interfere with NE quantitation.

L-Dopa and dopamine administration will increase levels of dopamine in urine.

Clinical Utility

Individual concentrations of epinephrine (E), norepinephrine (NE) and dopamine (D) are determined. This assay aids in distinguishing cases of suspected pheochromocytoma from other causes of episodic hypertensive symptoms (e.g., neurologic, psychologic, cardiac, and other endocrine disorders). Simultaneous determination of urinary metanephrines and vanillylmandelic acid (VMA) may be helpful.

CPT Codes

82384, 82570.
LOINC:  49257-9

Contacts

Last Updated

8/26/2024