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Catecholamines Fractionated by LC-MS/MS, Urine Free
Ordering Recommendation
Not recommended for the evaluation of pheochromocytoma or paraganglioma. Use to evaluate clinical symptoms of excess catecholamine secretion. For the assessment of pheochromocytoma or paraganglioma, refer to Metanephrines, Plasma (Free) (0050184) or Metanephrines Fractionated by HPLC-MS/MS, Urine (2007996).
New York DOH Approval Status
Specimen Required
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)
Refrigerated.
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
Methodology
Quantitative High Performance Liquid Chromatography-Tandem Mass Spectrometry
Performed
Sun-Sat
Reported
1-5 days
Reference Interval
| Test Number |
Components |
Reference Interval |
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|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Creatinine, Urine - per 24h |
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| Dopamine, Urine - per 24h |
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| Norepinephrine, Urine - per 24h |
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| Epinephrine, Urine - per 24h |
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| Norepinephrine, Urine - ratio to CRT |
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| Dopamine, Urine - ratio to CRT |
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| Epinephrine, Urine - ratio to CRT |
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Interpretive Data
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.
Per 24h calculations are provided to aid interpretation for collections with a duration of 24 hours and an average daily urine volume. For specimens with notable deviations in collection time or volume, ratios of analytes to a corresponding urine creatinine concentration may assist in result interpretation.
Laboratory Developed Test (LDT)
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 Chemistry1998;44:1759-62.).
Hotline History
Hotline History
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 |
Aliases
- Adrenaline
- Dopamine, Random
- Epinephrine, Random
- Fractionation, Catecholamines
- Free Catecholamine Fractionation
- Noradrenaline
- Norepinephrine, Random
