Ordering Recommendation

Not recommended for evaluation of pheochromocytoma or paraganglioma. Use to evaluate clinical symptoms of excess catecholamine secretion. For the assessment of pheochromocytoma and paraganglioma, refer to fractionated metanephrines in plasma (0050184) or urine (2007996).

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.
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.
Specimen preservation can be extended to 1 month refrigerated by performing one of the following:
  Option 1: Transfer a 4 mL aliquot to an ARUP Standard Transport Tube and adjust pH to 2.0-4.0 with 6M HCl. (Min: 2.5 mL)
  Option 2: Transfer a 4 mL aliquot to an ARUP Standard Transport Tube containing 20 mg sulfamic acid (ARUP Supply #48098), available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787. (Min: 2.5 mL)

Storage/Transport Temperature

Refrigerated.

Unacceptable Conditions

Specimens preserved with boric acid or acetic acid. Specimens with pH greater than 7.

Remarks

Record total volume and collection time interval on transport tube and test request form.

Stability

Unpreserved: Ambient: Unacceptable; Refrigerated: 1 week; Frozen: Undefined
Preserved:
Ambient: Unacceptable; Refrigerated: 1 month; Frozen: 6 months

Reference Interval
Reference Intervals for 24-Hour Calculations (24-Hour Urine)

Test Number
Components
Reference Interval
  Dopamine, Urine - per 24h
Effective November 18, 2019
Age
Dopamine
0-3 years Not Established
4-10 years 80-440 µg/d
11-17 years 100-496 µg/d
18 years and older 71-485 µg/d

  Epinephrine, Urine - per 24h
Effective August 19, 2019
Age
Epinephrine
0-3 years Not Established
4-10 years 1-14 µg/d
11-17 years 1-18 µg/d
18 years and older 1-14 µg/d

  Norepinephrine, Urine - per 24h
Effective November 18, 2019
Age
Norepinephrine
0-3 years Not Established
4-10 years 7-65 µg/d
11-17 years 12-96 µg/d
18 years and older 14-120 µg/d

0020473 Creatinine, Urine - per 24h
Age
Male
Female
3-8 years 140-700 mg/d 140-700 mg/d
9-12 years 300-1300 mg/d 300-1300 mg/d
13-17 years 500-2300 mg/d 400-1600 mg/d
18-50 years 1000-2500 mg/d 700-1600 mg/d
51-80 years 800-2100 mg/d 500-1400 mg/d
81 years and older 600-2000 mg/d 400-1300 mg/d

Reference Intervals for Ratio-to-Creatinine (CRT) Calculations (Random Urine)
Available Separately
Components
Reference Interval
Age Dopamine
No Dopamine 0-11 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
Age Epinephrine
No Epinephrine 0-11 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
Age Norepinephrine
No Norepinephrine 0-11 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: For laboratory developed tests not using a RUO kit, and for FDA approved, cleared or 510(k) exempt assays with alterations. 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).

Hotline History
N/A
CPT Codes

82384

Components
Component Test Code* Component Chart Name LOINC
0020207 Creatinine, Urine - per volume 2161-8
0020208 Creatinine, Urine - per 24h 2162-6
0080073 Catecholamines, Urine Interpretation 49256-1
0080217 Dopamine, Urine - per 24h 2218-6
0080218 Norepinephrine, Urine - per 24h 2668-2
0080219 Epinephrine, Urine - per 24h 2232-7
0081140 Epinephrine, Urine - per volume 11046-0
0081141 Norepinephrine, Urine - per volume 2667-4
0081142 Dopamine, Urine - per volume 2217-8
0093440 Norepinephrine, Urine - ratio to CRT 13782-8
0093441 Dopamine, Urine - ratio to CRT 13733-1
0093442 Epinephrine, Urine - ratio to CRT 13734-9
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.
Aliases
  • Adrenaline
  • Dopamine, Random
  • Epinephrine, Random
  • Fractionation, Catecholamines
  • Free Catecholamine Fractionation
  • Noradrenaline
  • Norepinephrine, Random
Catecholamines Fractionated by LC-MS/MS, Urine Free