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Test ID: VMAR Vanillylmandelic Acid (VMA), Random, Urine

Reporting Name

Vanillylmandelic Acid, Random, U

Useful For

Screening children for catecholamine-secreting tumors with a random urine collection when requesting vanillylmandelic acid only

 

Supporting a diagnosis of neuroblastoma

 

Monitoring patients with a treated neuroblastoma

Specimen Type

Urine


Specimen Required


Container/Tube: Plastic, 10-mL urine tube (T068)

Specimen Volume: 5 mL

Collection Instructions:

1. Collect a random urine specimen.

2. Adjust the random urine pH to a level between 1 and 5 by adding 50% acetic acid dropwise and checking the pH.

Additional Information:

1. Patient's age is required.

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


Specimen Minimum Volume

2 mL

Specimen Stability Information

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

Reference Values

<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 (adults): <7.0 mg/g creatinine

Day(s) and Time(s) Performed

Monday through Friday; 8 a.m.

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.

CPT Code Information

84585

LOINC Code Information

Test ID Test Order Name Order LOINC Value
VMAR Vanillylmandelic Acid, Random, U 3124-5

 

Result ID Test Result Name Result LOINC Value
60274 Vanillylmandelic Acid, Random, U 3124-5

Clinical Information

Vanillylmandelic acid (VMA) and other catecholamine metabolites (homovanillic acid [HVA] and dopamine) are typically elevated in patients with catecholamine-secreting tumors (eg, neuroblastoma, pheochromocytoma, and other neural crest tumors). VMA and HVA levels may also be useful in monitoring patients who have been treated as a result of one of the above-mentioned tumors.

Interpretation

Vanillylmandelic acid (VMA) and/or homovanillic acid concentrations are elevated in more than 90% of patients with neuroblastoma; both tests should be performed. A positive test could be due to a genetic or nongenetic condition. Additional confirmatory testing is required.

 

A normal result does not exclude the presence of a catecholamine-secreting tumor.

 

Elevated VMA values are suggestive of a pheochromocytoma, but they are not diagnostic.

Clinical Reference

1. Hyland K, Biaggioni I, Elpeleg ON, et al: Disorders of neurotransmitter metabolism. In Physician's Guide to the Laboratory Diagnosis of Metabolic Diseases. Edited by N Blau, M Duran, ME Blaskovics. London, UK, Chapman and Hall Medical, 1996, pp 79-98

2. Gitlow SE, Bertrani LM, Rausen A, et al: Diagnosis of neuroblastoma by qualitative and quantitative determination of catecholamine metabolites in urine. Cancer 1970;25(6):1377-1383

3. Strenger V, Kerbl R, Dornbusch HJ, et al: Diagnostic and prognostic impact of urinary catecholamines in neuroblastoma patients. Pediatr Blood Cancer 2007;48(5):504-509

4. Barco S, Gennai I, Reggiardo G, et al: Urinary homovanillic and vanillylmandelic acid in the diagnosis of neuroblastoma: report from the Italian Cooperative Group for Neuroblastoma. Clin Biochem 2014 June;47(9):848-852

Analytic Time

2 days (not reported on Sundays)

Method Name

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

Mayo Medical Laboratories | Genetics and Pharmacogenomics Catalog Additional Information:

mml-biochemical