Initial test for the diagnosis and monitoring of neuroblastoma; order concurrently with Vanillylmandelic Acid (VMA), Urine (0080421).
Quantitative High Performance Liquid Chromatography-Tandem Mass Spectrometry
Abstain from medications for 72 hours prior to collection.
24-hour or random urine. Refrigerate 24-hour specimens during collection.
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.
Specimen types other than urine.
Ambient: Unacceptable; Refrigerated: 1 week; Frozen: 2 weeks
Effective May 19, 2014
|Homovanillic Acid - per 24h||18 years and older: 0.0-15.0 mg/d|
|Homovanillic Acid - ratio to CRT||The HVA-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.
|Creatinine, Urine - per 24h||
Homovanillic acid (HVA) results are expressed as a ratio to creatinine excretion (mg/g CRT). HVA mass per day (mg/d) is not reported on specimens from patients younger than 18 years of age, or for random specimens, urine collection periods other than 24 hours, or urine volumes less than 400 mL/d. No reference interval is available for results reported in units of mg/L. Slight or moderate increases in catecholamine metabolites may be due to extreme anxiety, essential hypertension, intense physical exercise, or drug interactions. Significant increase of one or more catecholamine metabolites (several times the upper reference limit) is associated with an increased probability of a secreting 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.
Moderately elevated HVA (homovanillic acid) may 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), and vasodilators. The effects of some drugs on catecholamine metabolite results may not be predictable.
|Component Test Code*||Component Chart Name||LOINC|
|0020207||Creatinine, Urine - per volume||2161-8|
|0020208||Creatinine, Urine - per 24h||2162-6|
|0080164||Homovanillic Acid - per 24h||2436-4|
|0080399||Homovanillic Acid Interpretation||49269-4|
|0081305||Homovanillic Acid - per volume||53595-5|
|0081342||Homovanillic Acid - ratio to CRT||13760-4|
- 3-Methoxy-4-Hydroxy Phenylacetic Acid
- 3-Methoxy-4-hydroxyphenyl acetic acid
- 4-Hydroxy-3-methoxy-benzeneacetic acid
- 4-Hydroxy-3-methoxyphenylacetic acid