Quantitative High Performance Liquid Chromatography-Tandem Mass Spectrometry
Drugs and medications may affect results and should be discontinued for at least 72 hours prior to specimen collection, if possible.
24-hour or random urine. Refrigerate 24-hour specimen during collection.
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)
Specimens preserved with boric acid or acetic acid. Specimens with pH greater than 7.
Record total volume and collection time interval on transport tube and test request form.
Unpreserved: Ambient: Unacceptable; Refrigerated: 1 week; Frozen: Undefined
Preserved: Ambient: Unacceptable; Refrigerated: 1 month; Frozen: 6 months
|Reference Intervals for 24-Hour Calculations (24-Hour Urine)|
|Dopamine, Urine - per 24h||
|Epinephrine, Urine - per 24h||
|Norepinephrine, Urine - per 24h||
|0020473||Creatinine, Urine - per 24h||
|Reference Intervals for Ratio-to-Creatinine (CRT) Calculations (Random Urine)|
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
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
4 -10 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
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.
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).
|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|
- Dopamine, Random
- Epinephrine, Random
- Fractionation, Catecholamines
- Free Catecholamine Fractionation
- Norepinephrine, Random