Catecholamines Fractionated by LC-MS/MS, Urine Free
0080407
 
Ordering Recommendation
Not a first-line test for suspected catecholamine-secreting neuroendocrine tumors (pheochromocytoma or neuroblastoma).
Mnemonic
CATE UF
Methodology
Quantitative High Performance Liquid Chromatography-Tandem Mass Spectrometry
Performed
Sun-Sat
Reported
1-2 days
New York DOH Approval Status
This test is New York DOH approved.
Specimen Required
Patient Preparation
Drugs and medications may affect results and should be discontinued for at least 72 hours prior to specimen collection, if possible.  
Collect
24-hour or random urine. Refrigerate 24-hour specimen during collection.  
Specimen Preparation
Transfer a 4 mL aliquot from a well-mixed 24-hour or random collection to an ARUP Standard Transport Tube. (Min: 2.5 mL) Preservation can be enhanced by adjusting the pH to 2-3 by adding an acid such as 6 mol/L HCl. Catecholamines are not stable above pH 7. The pH of such specimens must be adjusted by the addition of acid prior to transport. A pH less than 2 can cause assay interference. Record total volume and collection time interval on transport tube and test request form.  
Storage/Transport Temperature
Refrigerated. Also acceptable: Frozen.  
Unacceptable Conditions
Room temperature specimens.  
Remarks
 
Stability
Ambient: Unacceptable; Refrigerated: 1 month; Frozen: 6 months  
Reference Interval
Reference Intervals for 24-​Hour Calculations (24-​Hour Urine)

Test Number
Components Reference Interval
Dopamine
Effective February 21, 2012
Age Dopamine
0-​17 years Not Established
18 years and older 60-​440 µg/d
Epinephrine
Effective February 21, 2012
Age Epinephrine
0-​17 years Not Established
18 years and older 0-​25 µg/d
Norepinephrine
Effective February 21, 2012
Age Norepinephrine
0-​17 years Not Established
18 years and older 0-​100 µg/d
0020473Creatinine, 24-​Hour Urine
Age Male Female
3-​8 years 140-​700 mg/d 140-​700 mg/d
9-​12 years 300-​1300 mg/d 300-​1300 mg/d
13-​17 years 500-​2300 mg/d 400-​1600 mg/d
18-​50 years 1000-​2500 mg/d 700-​1600 mg/d
51-​80 years 800-​2100 mg/d 500-​1400 mg/d
81 years and older 600-​2000 mg/d 400-​1300 mg/d

Reference Intervals for Ratio-​to-​Creatinine (CRT) Calculations (Random Urine)
Available Separately Components Reference Interval
Age Dopamine
No Dopamine 0-​11 months
1-​3 years
4-​10 years
11-​17 years
18 years and older
240-​1290 µg/g crt
80-​1220 µg/g crt
220-​720 µg/g crt
120-​450 µg/g crt
0-​250 µg/g crt
Age Epinephrine
No Epinephrine 0-​11 months
1-​3 years
4-​10 years
11-​17 years
18 years and older
0-​380 µg/g crt
0-​82 µ/g crt
5-​93 µg/g crt
3-​58 µg/g crt
0-​20 µg/g crt
Age Norepinephrine
No Norepinephrine 0-​11 months
1-​3 years
4 -​10 years
11-​17 years
18 years and older
25-​310 µg/g crt
25-​290 µg/g crt
27-​110 µg/g crt
4-​105 µg/g crt
0-​45 µg/g crt
Interpretive Data
The optimal specimen for this testing is a 24-hour urine collection. Mass per day calculations are not reported for patients younger than 18 years of age and for the following specimen types: a random collection, a collection with duration of less than 20 hours, a collection with duration of greater than 28 hours, or a collection with total volume less than 400 mL. Ratios to creatinine may be useful for these evaluations.

Smaller increases in catecholamine concentrations (less than two times the upper limit) usually are the result of physiological stimuli, drugs, or improper specimen collection. Significant elevation of one or more catecholamines (three or more times the upper reference limit) is associated with an increased probability of a neuroendocrine tumor.

See Compliance Statement B: www.aruplab.com/CS
Note
Secreting neuroendocrine tumors are typically associated with catecholamine concentrations several times higher than the upper reference intervals. Large elevations can be seen in life-threatening illnesses and drug interferences. Common reasons for slight and moderate elevations include intense physical activity, emotional and physical stress, drug interferences, and improper specimen collection.

Medications which may physiologically interfere with catecholamines and metabolites include amphetamines and amphetamine-like compounds, appetite suppressants, bromocriptine, buspirone, caffeine, carbidopa-levodopa (Sinemet), clonidine, dexamethasone, diuretics (in doses sufficient to deplete sodium), ethanol, isoproterenol, methyldopa (Aldomet), MAO inhibitors, nicotine, nose drops, propafenone (Rythmol), reserpine, theophylline, tricyclic antidepressants, and vasodilators. The effects of some drugs on catecholamine results may not be predictable.

References: 1) Optimal collection and storage conditions for catecholamine measurements in human plasma and urine. (Clinical Chemistry 1993; 39:2503-8.); 2) Effect of urine pH, storage time, and temperature on stability of catecholamines, cortisol, and creatinine. (Clinical Chemistry 1998; 44: 1759-62).
CPT Code(s)
82384
Components
Component Test Code*Component Chart Name
0020207Creatinine, Urine - per volume
0020208Creatinine, Urine - per 24h
0080073Catecholamines, Urine Interpretation
0080217Dopamine, Urine - per 24h
0080218Norepinephrine, Urine - per 24h
0080219Epinephrine, Urine - per 24h
0081140Epinephrine, Urine - per volume
0081141Norepinephrine, Urine - per volume
0081142Dopamine, Urine - per volume
0093440Norepinephrine, Urine - ratio to CRT
0093441Dopamine, Urine - ratio to CRT
0093442Epinephrine, Urine - ratio to CRT
0097110Total Volume
0097111Hours Collected
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, contact interface support at interface.support@aruplab.com.
Cross References
  • Adrenaline
  • Dopamine, Random
  • Epinephrine, Random
  • Fractionation, Catecholamines
  • Free Catecholamine Fractionation
  • Noradrenaline
  • Norepinephrine, Random