Ordering Recommendation

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).​

Mnemonic

CATE PF,EN

Methodology

Quantitative High Performance Liquid Chromatography

Performed

Sun, Tue-Sat

Reported

1-4 days

New York DOH Approval Status

This test is New York DOH approved.

Specimen Required

Patient Preparation

Patient should be calm and supine for 30 minutes prior to collection. Drugs and medications may affect results and should be discontinued for 72 hours prior to specimen collection, if possible.

Collect

Green (sodium or lithium heparin). Collect on ice.

Specimen Preparation

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)

Storage/Transport Temperature

CRITICAL FROZEN. Separate specimens must be submitted when multiple tests are ordered.

Unacceptable Conditions

EDTA plasma, serum, or urine.

Remarks
Stability

After separation from cells: Ambient: Unacceptable; Refrigerated: Unacceptable; Frozenat -20°C: 1 month; Frozen at -70°C: 1 year

Reference Interval

Supine

Test Number
Components
Reference Interval
  Epinephrine
Age
Reference Interval (pg/mL)
2-10 days
11 days-3 months
4-11 months
12-23 months
24-35 months
3-17 years
18 years and older
36-400
55-200
55-440
36-640
18-440
18-460
10-200

  Norepinephrine
Age
Reference Interval (pg/mL)
2-10 days
11 days-3 months
4-11 months
12-23 months
24-35 months
3-17 years
18 years and older
170-1180
370-2080
270-1120
68-1810
170-1470
85-1250
80-520

Interpretive Data

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.

Compliance Category

Laboratory Developed Test (LDT)

Note

Medications that may interfere with catecholamines and metabolites include amphetamines and amphetamine-like compounds, alpha-blockers (phenoxybenzamine), beta-blockers (including labetalol), caffeine, calcium channel antagonists, carbidopa, cocaine, ephedrine, levodopa, monoamine oxidase inhibitors, nicotine, pseudoephedrine, theophylline, tricyclic antidepressants, and vasodilators. The effect of drugs on catecholamine results may not be predictable. (Rifai, Nader,, Andrea R. Horvath, and C. 1955- Wittwer. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. Sixth edition. St. Louis, Missouri: Elsevier, 2018; Table 63.9.)

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.

Hotline History

N/A

CPT Codes

82384

Components

Component Test Code* Component Chart Name LOINC
0080212 Epinephrine 2230-1
0080213 Norepinephrine 2666-6
0080960 Catecholamine Interpretation 48767-8
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.

Aliases

  • Adrenalin
  • Dopamine
  • Epinephrine
  • Noradrenaline
  • Norepinephrine
Catecholamines Fractionated (Epinephrine, Norepinephrine), Plasma