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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
1-4 days
New York DOH Approval Status
This test is New York DOH approved.
Submit With Order
ARUP Consult®
Disease Topics
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. Record total volume and collection time interval on transport tube and test request form.
Specimen preservation can be extended to 1 month refrigerated by performing one of the following:
Option 1: Transfer a 4 mL aliquot (Min: 2.5 mL) to an ARUP Standard Transport Tube. Adjust pH to 2.0-4.0 with 6M HCl.
Option 2: Transfer a 4 mL aliquot (Min: 2.5 mL) to an ARUP Standard Transport Tube containing 20 mg sulfamic acid (ARUP Supply #48098), available online through eSupply using ARUP Connector contact ARUP Client Services at (800) 522-2787. (Min: 2.5 mL).  
Storage/Transport Temperature
Refrigerated. Also acceptable: Frozen.  
Unacceptable Conditions
Room temperature specimens. Specimens preserved with boric acid or acetic acid. Specimens with pH greater than 7.  
Remarks
 
Stability
Ambient: Unacceptable; Refrigerated: 1 week (unpreserved), 1 month (preserved); Frozen: 6 months (preserved)  
Reference Interval
Reference Intervals for 24-Hour Calculations (24-Hour Urine)

Test Number
Components
Reference Interval
 Dopamine, Urine - per 24h
Effective August 17, 2015
Age
Dopamine
0-3 yearsNot Established
4-6 years95-221 µg/d
7-12 years76-371 µg/d
13-17 years137-393 µg/d
18-69 years77-324 µg/d
70 years and older56-272 µg/d

 Epinephrine, Urine - per 24h
Effective August 17, 2015
AgeEpinephrine
0-3 yearsNot Established
4-17 years1-9 µg/d
18-69 years1-7 µg/d
70 years and older1-5 µg/d

 Norepinephrine, Urine - per 24h
Effective August 17, 2015
AgeNorepinephrine
0-3 yearsNot Established
4-12 years6-45 µg/d
13-17 years15-57 µg/d
18-69 years16-71 µg/d
70 years and older11-60 µg/d

0020473Creatinine, 24-Hour Urine
Age
Male
Female
3-8 years140-700 mg/d140-700 mg/d
9-12 years300-1300 mg/d300-1300 mg/d
13-17 years500-2300 mg/d400-1600 mg/d
18-50 years1000-2500 mg/d700-1600 mg/d
51-80 years800-2100 mg/d500-1400 mg/d
81 years and older600-2000 mg/d400-1300 mg/d


Reference Intervals for Ratio-to-Creatinine (CRT) Calculations (Random Urine)
Available Separately
Components
Reference Interval
AgeDopamine
NoDopamine0-11 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
AgeEpinephrine
NoEpinephrine0-11 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
AgeNorepinephrine
NoNorepinephrine0-11 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 4 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 (if 18 years of age or older) or greater than 5000 mL (all ages). 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.


Compliance Statement B: This test was developed and its performance characteristics determined by ARUP Laboratories. The U.S. Food and Drug Administration has not approved or cleared this test; however, FDA clearance or approval is not currently required for clinical use. The results are not intended to be used as the sole means for clinical diagnosis or patient management decisions.
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 NameLOINC
0020207Creatinine, Urine - per volume2161-8
0020208Creatinine, Urine - per 24h2162-6
0080073Catecholamines, Urine Interpretation49256-1
0080217Dopamine, Urine - per 24h2218-6
0080218Norepinephrine, Urine - per 24h2668-2
0080219Epinephrine, Urine - per 24h2232-7
0081140Epinephrine, Urine - per volume11046-0
0081141Norepinephrine, Urine - per volume2667-4
0081142Dopamine, Urine - per volume2217-8
0093440Norepinephrine, Urine - ratio to CRT13782-8
0093441Dopamine, Urine - ratio to CRT13733-1
0093442Epinephrine, Urine - ratio to CRT13734-9
0097110Total Volume19153-6
0097111Hours Collected30211-7
* 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