Ordering Recommendation

Not recommended for the evaluation of pheochromocytoma or paraganglioma. Use to evaluate clinical symptoms of excess catecholamine secretion. For the assessment of pheochromocytoma or paraganglioma, refer to Metanephrines, Plasma (Free) (0050184) or Metanephrines Fractionated by HPLC-MS/MS, Urine (2007996).

New York DOH Approval Status

This test is New York state 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

Thoroughly mix entire collection (24-hour or random) in one container. Transfer a 4 mL aliquot to an ARUP standard transport tube. (Min: 2.5 mL) Catecholamines are not stable above pH 7. The pH of such specimens must be adjusted by the addition of 6M HCl acid or sulfamic acid prior to transport. A pH less than 2 can cause assay interference.
Specimen preservation can be extended to 1 month refrigerated by performing one of the following:
  Option 1: Transfer a 4 mL aliquot to an ARUP standard transport tube and adjust pH to 2.0-4.0 with 6M HCl. (Min: 2.5 mL)
  Option 2: Transfer a 4 mL aliquot to an ARUP standard transport tube containing 20 mg sulfamic acid (ARUP Supply #48098), available online through eSupply using ARUP Connect™ or contact ARUP Client Services at 800-522-2787. (Min: 2.5 mL)

Storage/Transport Temperature

Refrigerated.

Unacceptable Conditions

Specimens preserved with boric acid or acetic acid. Specimens with pH greater than 7.

Remarks

Record total volume and collection time interval on transport tube and test request form.

Stability

Unpreserved: Ambient: Unacceptable; Refrigerated: 1 week; Frozen: Undefined
Preserved: Ambient:
Unacceptable; Refrigerated: 1 month; Frozen: 6 months

Methodology

Quantitative High Performance Liquid Chromatography-Tandem Mass Spectrometry

Performed

Sun-Sat

Reported

1-5 days

Reference Interval

Test Number
Components
Reference Interval
  Creatinine, Urine - per 24h
Age
Male (mg/d)
Female (mg/d)
3-8 years 140-700 140-700
9-12 years 300-1300 300-1300
13-17 years 500-2300 400-1600
18-50 years 1000-2500 700-1600
51-80 years 800-2100 500-1400
81 years and older 600-2000 400-1300

  Dopamine, Urine - per 24h
Age ug/d
0-3 years Not established
4-10 years 80-440
11-17 years 100-496
18 years and older 71-485

  Norepinephrine, Urine - per 24h
Age
ug/d
0-3 years Not established
4-10 years 7-65
11-17 years 12-96
18 years and older 14-120

  Epinephrine, Urine - per 24h
Age ug/d
0-3 years Not established
4-10 years 1-14
11-17 years 1-18
18 years and okder 1-14

  Norepinephrine, Urine - ratio to CRT
Age
ug/g CRT
0-11 months 25-310
1-3 years 25-290
4-10 years 27-110
11-17 years 4-105
18 years and older 0-45

  Dopamine, Urine - ratio to CRT
Age ug/g CRT
0-11 months 240-1290
1-3 years 80-1220
4-10 years 220-720
11-17 years 120-450
18 years and older 0-250

  Epinephrine, Urine - ratio to CRT
Age ug/g CRT
0-11 months 0-380
1-3 years 0-82
4-10 years 5-93
11-17 years 3-58
18 years and older 0-20

Interpretive Data

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.

Per 24h calculations are provided to aid interpretation for collections with a duration of 24 hours and an average daily urine volume. For specimens with notable deviations in collection time or volume, ratios of analytes to a corresponding urine creatinine concentration may assist in result interpretation.

Compliance Category

Laboratory Developed Test (LDT)

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 Chemistry1998;44:1759-62.).

Hotline History

N/A

CPT Codes

82384

Components

Component Test Code* Component Chart Name LOINC
0020207 Creatinine, Urine - per volume 2161-8
0020208 Creatinine, Urine - per 24h 2162-6
0080073 Catecholamines, Urine Interpretation 49256-1
0080217 Dopamine, Urine - per 24h 2218-6
0080218 Norepinephrine, Urine - per 24h 2668-2
0080219 Epinephrine, Urine - per 24h 2232-7
0081140 Epinephrine, Urine - per volume 11046-0
0081141 Norepinephrine, Urine - per volume 2667-4
0081142 Dopamine, Urine - per volume 2217-8
0093440 Norepinephrine, Urine - ratio to CRT 13782-8
0093441 Dopamine, Urine - ratio to CRT 13733-1
0093442 Epinephrine, Urine - ratio to CRT 13734-9
0097110 Total Volume 19153-6
0097111 Hours Collected 30211-7
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.

Aliases

  • Adrenaline
  • Dopamine, Random
  • Epinephrine, Random
  • Fractionation, Catecholamines
  • Free Catecholamine Fractionation
  • Noradrenaline
  • Norepinephrine, Random
Catecholamines Fractionated by LC-MS/MS, Urine Free