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 Metanephrines, Plasma (Free) (0050184) or Metanephrines Fractionated by HPLC-MS/MS, Urine (2007996).
Quantitative High Performance Liquid Chromatography
New York DOH Approval Status
Patient should be calm and supine for 30 minutes prior to collection.
Green (sodium or lithium heparin). Collect on ice.
Specimen should be centrifuged and frozen within one hour (refrigerated centrifuge is preferred but not required). Transfer 4 mL plasma to an ARUP Standard Transport Tube. (Min: 2.1 mL)
CRITICAL FROZEN. Separate specimens must be submitted when multiple tests are ordered.
EDTA plasma, serum, or urine.
After separation from cells: Ambient: Unacceptable; Refrigerated: Unacceptable; Frozenat -20°C: 1 month; Frozen at -70°C: 1 year
Small increases in catecholamines (less than 2 times the upper reference limit) usually are the result of physiological stimuli, drugs, or improper specimen collection. Significant elevation of one or more catecholamines (2 or more times the upper reference limit) is associated with an increased
probability of a neuroendocrine tumor. Measurement of plasma or urine fractionated metanephrines provides better diagnostic sensitivity than measurement of catecholamines.
Higher catecholamine concentrations are observed in specimens collected from upright or standing adults. Epinephrine may be increased by approximately 20 percent and norepinephrine increased up to 700 pg/mL.
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)
Medications that may 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, labetalol, methyldopa (Aldomet), MAO inhibitors, nicotine, nose drops, propafenone (Rythmol), reserpine, theophylline, tricyclic antidepressants, and vasodilators. The effect of drugs on catecholamine results may not be predictable.
For optimum results, patient should be supine for 30 minutes prior to collection.
Children, particularly those under 2 years of age, often show an elevated catecholamine response to stress.
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