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Homovanillic Acid (HVA), 24-Hour Urine (Southeast Michigan Only)

Test Codes

EPIC: LAB5864, Beaker: XMISC, MAYO: HVA

Department

Send Outs

Instructions

 

• Please refer to the Specimen Collection Manual for instructions on 24-Hour Urine Collection:
• Urine 24-Hour Collection - Inpatient.
• Urine 24-Hour Collection - Outpatient.
• Urine 24-Hour Collection - Outreach.

• Patient Preparation: Administration of L-dopa may falsely increase homovanillic acid results; it should be discontinued 24 hours prior to and during collection of specimen. Bactrim may interfere with detection of the analyte. All patients taking Bactrim should be identified to the laboratory when this test is ordered.

Specimen Collection Criteria

Collect (preferred specimen): 24-hour urine with 50% acetic acid preservative. This preservative is intended to achieve a pH of between approximately 1 and 5. 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.
• The specimen must be transported to the Laboratory immediately after the end of the collection interval.

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

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 5.0 mL from the preserved, well-mixed 24-hour urine collection. (Minimum: 2.0 mL)

Storage

Specimen Stability for Testing:

Room temperature (20-26°C or 68-78.8°F): Unacceptable
Refrigerated (with preservative) (2-8°C or 36-46°F): 28 days
Frozen (-20°C/-4°F or below): 180 days

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 A Mayo Clinic Laboratories in Rochester, MN.

Performed

Monday – Friday.
Results available in 2-4 days.

Reference Range

By report.

Test Methodology

Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS).

Interpretation

HVA is the primary metabolite of dopamine and elevations reflect increased dopamine levels due to either a tumor or drug therapy. Levels can be extremely elevated in urines from patients receiving dopamine, L-dopa, disulfiram and reserpine.

Clinical Utility

This assay is helpful in the diagnosis of pheochromocytoma, neuroblastoma, or ganglio-blastoma and to monitor the patient's response to therapy. If neuroblastoma is suspected, it is best to determine Vanillylmandelic Acid (VMA), Urine levels since either dopamine or norepinephrine could be increased.

CPT Codes

83150

Contacts

Last Updated

10/31/2024