Patient Preparation

Abstain from medications for 72 hours prior to collection. 

Collect

24-hour or random urine. Refrigerate 24-hour specimens during collection. 

Specimen Preparation

Transfer 4 mL aliquot from a well-mixed 24-hour or random collection to an ARUP Standard Transport Tube. (Min: 1 mL) Record total volume and collection time interval on transport tube and test request form. 

Storage/Transport Temperature

Refrigerated. 

Unacceptable Conditions

Specimen types other than urine. 

Remarks

 

Stability

Ambient: Unacceptable; Refrigerated: 1 week; Frozen: 2 weeks 

Components	Reference Interval
Vanillylmandelic Acid - per 24h	18 years and older	0.0-7.0 mg/d
	The VMA-to-creatinine ratio will be reported when the patient is under 18 years, the urine collection is random or other than 24 hours, or the urine volume is less than 400 mL/24 hours
Vanillylmandelic Acid - ratio to CRT	0-2 years 3-5 years  6-17 years 18 years and older	0-27 mg/g CRT 0-13 mg/g CRT 0-9 mg/g CRT 0-6 mg/g CRT
Creatinine, Urine - per 24h	Male 3-8 years: 140-700 mg/d 9-12 years: 300-1300 mg/d 13-17 years: 500-2300 mg/d 18-50 years: 1000-2500 mg/d 51-80 years: 800-2100 mg/d 81 years and older: 600-2000 mg/d	Female 3-8 years: 140-700 mg/d 9-12 years: 300-1300 mg/d 13-17 years: 400-1600 mg/d 18-50 years: 700-1600 mg/d 51-80 years: 500-1400 mg/d 81 years and older: 400-1300 mg/d

Vanillylmandelic acid (VMA) results are expressed as a ratio to creatinine excretion (mg/g CRT). VMA mass per day (mg/d) is not reported on specimens from patients younger than 18 years of age, or for random specimens, urine collection periods other than 24 hours, or urine volumes less than 400 mL/d. No reference interval is available for results reported in units of mg/L. Slight or moderate increases in catecholamine metabolites may be due to extreme anxiety, essential hypertension, intense physical exercise, or drug interactions. Significant increase of one or more catecholamine metabolites (several times the upper reference limit) is associated with an increased probability of a secreting neuroendocrine tumor.

Moderately elevated VMA (vanillylmandelic acid) can be caused by a variety of factors such as essential hypertension, intense anxiety, intense physical exercise, and numerous drug interactions (including some over-the-counter medications and herbal products).

Medications that may interfere with catecholamines and their metabolites include amphetamines and amphetamine-like compounds, appetite suppressants, bromocriptine, buspirone, caffeine, chlorpromazine, clonidine, disulfiram, diuretics (in doses sufficient to deplete sodium), epinephrine, glucagon, guanethidine, histamine, hydrazine derivatives, imipramine, levodopa (L-dopa, Sinemet®), lithium, MAO inhibitors, melatonin, methyldopa (Aldomet®), morphine, nitroglycerin, nose drops, propafenone (Rythmol), radiographic agents, rauwolfia alkaloids (Reserpine), tricyclic antidepressants, and vasodilators.  The effects of some drugs on catecholamine metabolite results may not be predictable.

84585

Component Test Code*	Component Chart Name	LOINC
0020207	Creatinine, Urine - per volume	2161-8
0020208	Creatinine, Urine - per 24h	2162-6
0080401	Vanillylmandelic Acid - per 24h	3122-9
0080402	Vanillylmandelic Acid Interpretation	50948-9
0081306	Vanillylmandelic Acid - per volume	26706-2
0081341	Vanillylmandelic Acid - ratio to CRT	30571-4
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.

• 3-Methoxy-4-Hydroxy-Mandelic Acid
• 3-Methoxy-4-Hydroxymandelic Acid
• 4-Hydroxy-3-Methoxymandelic Acid
• VMA