Vanillylmandelic Acid (VMA), Urine
0080421
Ordering Recommendation
Initial test for the diagnosis and monitoring of individuals with neuroblastoma. Should be ordered concurrently with Homovanillic Acid (HVA), Urine (0080422).
Mnemonic
VMA U
Methodology
Quantitative High Performance Liquid Chromatography
Performed
Sun, Tue-Sat
Reported
1-4 days
New York DOH Approval Status
This test is New York DOH approved.
Submit With Order
Specimen Required
- 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
Reference Interval
| Components | Reference Interval | |
| VMA, Urine | 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 | ||
| VMA, Urine | 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 (24 hour) | 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 |
Interpretive Data
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.
Note
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.
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.
CPT Code(s)
84585
Components
| Component Test Code* | Component Chart Name | LOINC |
|---|---|---|
| 0020207 | Creatinine, Urine - per volume | 20624-3 |
| 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 |
Aliases
- 3-Methoxy-4-Hydroxy-Mandelic Acid
- 3-Methoxy-4-Hydroxymandelic Acid
- 4-Hydroxy-3-Methoxymandelic Acid
- VMA