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Test ID VH Vanillylmandelic Acid (VMA) and Homovanillic Acid (HVA), Random, Urine

Useful For

First preferred test for screening for catecholamine-secreting tumors in a random urine specimen when requesting both homovanillic acid and vanillylmandelic acid

 

Supporting a diagnosis of neuroblastoma

 

Monitoring patients with a treated neuroblastoma

Highlights

Homovanillic acid (HVA) and vanillylmandelic acid (VMA) measurements in urine are used for screening children for catecholamine-secreting tumors such as neuroblastoma, pheochromocytoma, and other neural crest tumors and monitoring those who have had treatment for these tumors.

 

HVA measurement is also useful to diagnose children with disorders of catecholamine metabolism such as monoamine oxidase-A deficiency and dopamine beta-hydroxylase deficiency, which results in decreased or elevated urinary HVA values, respectively.

 

VMA is not the analyte of choice for diagnosis of pheochromocytoma, which is better detected by testing for metanephrines.

 

Treatment with L-dopa can impact test results and should be discontinued 24 hours prior to collection. Bactrim can impact test results and should be noted at time of collection.

Method Name

Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)

Reporting Name

VMA and HVA, Random, U

Specimen Type

Urine

Specimen Required

Patient Preparation: Administration of L-dopa may falsely increase homovanillic acid and vanillylmandelic acid results; it should be discontinued 24 hours prior to and during collection of specimen.

Supplies: Urine Tubes, 10 mL (T068)

Specimen Volume: 5 mL

Collection Instructions:

1. Collect a random urine specimen.

2. Adjust urine pH to 1 to 5 with 50% acetic or HCl acid.

Specimen Minimum Volume

2 mL

Specimen Stability Information

Specimen Type Temperature Time
Urine Refrigerated (preferred) 28 days
  Frozen  180 days

Reference Values

VANILLYLMANDELIC ACID

<1 year: <25.0 mg/g creatinine

1 year: <22.5 mg/g creatinine

2-4 years: <16.0 mg/g creatinine

5-9 years: <12.0 mg/g creatinine

10-14 years: <8.0 mg/g creatinine

≥15 years: <7.0 mg/g creatinine

 

HOMOVANILIC ACID

<1 year: <35.0 mg/g creatinine

1 year: <30.0 mg/g creatinine

2-4 years: <25.0 mg/g creatinine

5-9 years: <15.0 mg/g creatinine

10-14 years: <9.0 mg/g creatinine

≥15 years: <8.0 mg/g creatinine

Day(s) and Time(s) Performed

Monday through Friday; 8 a.m.

Performing Laboratory

Mayo Medical Laboratories in Rochester

CPT Code Information

83150-HVA

84585-VMA

LOINC Code Information

Result ID Test Result Name Result LOINC Value
2143 Vanillylmandelic Acid, VH 3124-5
2144 Homovanillic Acid, VH 11146-8

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

Forms

If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:

Neurology Test Request Form-General (T732) (http://www.mayomedicallaboratories.com/it-mmfiles/neurology-request-form.pdf)

Oncology Test Request Form (T729) (http://www.mayomedicallaboratories.com/it-mmfiles/oncology-request-form.pdf)

Necessary Information

1. Patient's age is required.

2. All patients receiving L-dopa should be identified to the laboratory when vanillylmandelic acid (VMA) and homovanillic acid (HVA) tests are ordered.

3. Bactrim may interfere with detection of the analyte. All patients taking Bactrim should be identified to the laboratory when VMA and HVA tests are ordered.

Advisory Information

In the past, this test has been used to screen for pheochromocytoma. However, vanillylmandelic acid (VMA) is not the analyte of choice to rule out a diagnosis of pheochromocytoma. Recommended tests for that purpose include:

-PMET / Metanephrines, Fractionated, Free, Plasma

-METAF / Metanephrines, Fractionated, 24 Hour, Urine

-CATU / Catecholamine Fractionation, Free, 24 Hour, Urine