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Vanillylmandelic Acid (VMA) and Homovanillic Acid (HVA), Random Urine

VH RAND

Ordering Recommendation

Initial test for the diagnosis and monitoring of neuroblastoma.

New York DOH Approval Status

This test is New York state approved.

Specimen Required

Patient Preparation

Abstain from medications for 72 hours prior to collection.

Collect

Random urine.

Specimen Preparation

Transfer 4 mL aliquot from a well mixed random collection to an ARUP standard transport tube. (Min: 1 mL)

Storage/Transport Temperature

Refrigerated.

Unacceptable Conditions

Specimen types other than urine.

Remarks
Stability

Ambient: Unacceptable; Refrigerated: 1 week; Frozen: 2 weeks

Methodology

Quantitative High Performance Liquid Chromatography-Tandem Mass Spectrometry

Performed

Sun, Tue, Wed, Thu, Fri, Sat

Reported

1-5 days

Reference Interval

Test Number
 Components
 Reference Interval
  Homovanillic Acid - ratio to CRT
Age mg/g CRT
0-2 years 0-42
3-5 years 0-22
6-17 years 0-15
18 years and older 0-8

  Vanillylmandelic Acid - ratio to CRT
Age mg/g CRT
0-2 years 0-27
3-5 years 0-13
6-17 years 0-9
18 years and older 0-6

Interpretive Data

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.

Compliance Category

Laboratory Developed Test (LDT)

Note

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.

Hotline History

View Hotline History

 

Hotline History

Date of Change
Test Name Change
Methodology
Performance/Reported Schedule
Specimen Requirements
Reference Interval
Interpretive Data
Note
CPT Code
Component Change
Other Interface Change
New Test
Inactive
03/04/2025
X
N/A

CPT Codes

83150; 84585

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Components

Component Test Code* Component Chart Name LOINC
0020207 Creatinine, Urine - per volume 2161-8
0080398 VMA and HVA Interpretation 48767-8
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
* 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

  • 4-Hydroxy-3-methoxyphenylacetic acid
  • 3-methoxy-4-hydroxymandelic acid
  • HVA
  • HVA and VMA
  • 4-Hydroxy-3-Methoxymandelic Acid
  • 4-Hydroxy-3-methoxy-benzeneacetic acid
  • 3-Methoxy-4-hydroxyphenyl acetic acid
Vanillylmandelic Acid (VMA) and Homovanillic Acid (HVA), Random Urine