Vanillylmandelic Acid (VMA) & Homovanillic Acid (HVA), Urine
0080470
 
Ordering Recommendation
Initial test for the diagnosis and monitoring of individuals with neuroblastoma.
Mnemonic
VH
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 specimen 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
HVA, Urine 18 years and older 0.0-​15.0 mg/d
VMA, Urine 18 years and older 0.0-​7.0 mg/d
The HVA-​to-​creatinine ration and 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.
HVA, Urine 0-​2 years
3-​5 years
6-​17 years
18 years and older
0-​42 mg/g crt
0-​22 mg/g crt
0-​15 mg/g crt
0-​8 mg/g crt
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) and homovanillic acid (HVA) results are expressed as a ratio to creatinine excretion (mg/g cr). VMA and HVA 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 HVA (homovanillic acid) and 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 predicable.
CPT Code(s)
83150; 84585
Components
Component Test Code*Component Chart Name
0020207Creatinine, Urine - per volume
0020208Creatinine, Urine - per 24h
0080164Homovanillic Acid - per 24h
0080398VMA and HVA Interpretation
0080401Vanillylmandelic Acid - per 24h
0081305Homovanillic Acid - per volume
0081306Vanillylmandelic Acid - per volume
0081341Vanillylmandelic Acid - ratio to CRT
0081342Homovanillic Acid - ratio to CRT
0097110Total Volume
0097111Hours 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-hydroxymandelic acid
  • 3-Methoxy-4-hydroxyphenyl acetic acid
  • 4-Hydroxy-3-methoxy-benzeneacetic acid
  • 4-Hydroxy-3-Methoxymandelic Acid
  • 4-Hydroxy-3-methoxyphenylacetic acid
  • HVA
  • HVA and VMA