Vanillylmandelic Acid (VMA), Urine

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

1-3 days

New York DOH Approval Status

This test is New York DOH approved.

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 cr). VMA mass per day (mg/d) is not reported on specimens from patients younger than 18 years of age, for random specimens, urine collection periods other than 24 hours, or for urine volumes less than 400 mL/d. No reference interval is available for results reported in units of mg/L.

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.

CPT Code(s)

84585

Components

Component Test Code*	Component Chart Name
0020207	Creatinine, Urine - per volume
0020208	Creatinine, Urine - per 24h
0080401	Vanillylmandelic Acid - per 24h
0080402	Vanillylmandelic Acid Interpretation
0081306	Vanillylmandelic Acid - per volume
0081341	Vanillylmandelic Acid - ratio to CRT
0097110	Total Volume
0097111	Hours 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

3-Methoxy-4-Hydroxy-Mandelic Acid
VMA

Laboratory Test Directory