Initial test for the diagnosis and monitoring of neuroblastoma.
Quantitative High Performance Liquid Chromatography-Tandem Mass Spectrometry
New York DOH Approval Status
Abstain from medications for 72 hours prior to collection.
24-hour or random urine. Refrigerate 24-hour specimen 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
|Creatinine, Urine - per 24h||
|Homovanillic Acid - per 24h||18 years and older: 0.0-15.0 mg/d|
|Vanillylmandelic Acid - per 24h||18 years and older: 0.0-7.0 mg/d|
|Vanillylmandelic Acid - ratio to CRT||
|Homovanillic Acid - ratio to CRT||
Vanillylmandelic acid (VMA) and homovanillic acid (HVA) results are expressed as a ratio to creatinine excretion (mg/g CRT). 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.
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.
This test was developed and its performance characteristics determined by ARUP Laboratories. It has not been cleared or approved by the US Food and Drug Administration. This test was performed in a CLIA certified laboratory and is intended for clinical purposes.
Laboratory Developed Test (LDT)
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.
|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|
|0080398||VMA and HVA Interpretation||48767-8|
|0080401||Vanillylmandelic Acid - per 24h||3122-9|
|0081305||Homovanillic Acid - per volume||11144-3|
|0081306||Vanillylmandelic Acid - per volume||9624-8|
|0081341||Vanillylmandelic Acid - ratio to CRT||30571-4|
|0081342||Homovanillic Acid - ratio to CRT||13760-4|
- 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 and VMA