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HelpTest ID: HVAR Homovanillic Acid, Random, Urine
Reporting Name
Homovanillic Acid (HVA), Random, UUseful For
Screening children for catecholamine-secreting tumors with a random urine collection when requesting homovanillic acid only
Monitoring neuroblastoma treatment
Screening patients with possible inborn errors of catecholamine metabolism
Specimen Type
UrineNecessary Information
1. Patient's age is required.
2. All patients receiving L-dopa should be identified to the laboratory when this test is ordered.
3. Bactrim may interfere with detection of the analyte. All patients taking Bactrim should be identified to the laboratory when this test is ordered.
Specimen Required
Patient Preparation: Administration of L-dopa may falsely increase homovanillic acid results; it should be discontinued 24 hours prior to and during collection of specimen.
Supplies: Urine Tubes, 10 mL (T068)
Collection Container/Tube: Clean, plastic urine collection container
Submission Container/Tube: Plastic, 10-mL urine tube
Specimen Volume: 5 mL
Collection Instructions:
1. Collect a random urine specimen.
2. Adjust the urine pH to a level between 1 and 5 by adding 50% acetic acid dropwise and checking the pH.
Specimen Minimum Volume
2 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Urine | Refrigerated (preferred) | 28 days | |
| Frozen | 180 days |
Reference Values
<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 (adults): <8.0 mg/g creatinine
Day(s) Performed
Monday through Friday
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 US Food and Drug Administration.CPT Code Information
83150
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| HVAR | Homovanillic Acid (HVA), Random, U | 11146-8 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 60275 | Homovanillic Acid (HVA), Random, U | 11146-8 |
Clinical Information
Homovanillic acid (HVA) and other catecholamine metabolites (vanillylmandelic acid: VMA and dopamine) are typically elevated in patients with catecholamine-secreting tumors (eg, neuroblastoma, pheochromocytoma, and other neural crest tumors). HVA and VMA levels may also be useful in monitoring patients who have been treated as a result of the above-mentioned tumors. HVA levels may also be altered in disorders of catecholamine metabolism; monoamine oxidase-A deficiency can cause decreased urinary HVA values, while a deficiency of dopamine beta-hydrolase (the enzyme that converts dopamine to norepinephrine) can cause elevated urinary HVA values.
Interpretation
Vanillylmandelic acid and/or homovanillic acid (HVA) concentrations are elevated in over 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 HVA values are suggestive of a deficiency of dopamine beta-hydrolase, a neuroblastoma, a pheochromocytoma, or may reflect administration of L-dopa.
Decreased urinary HVA values may suggest monoamine oxidase-A deficiency.
Clinical Reference
2. Hyland K: Presentation, diagnosis, and treatment of the disorders of monoamine neurotransmitter metabolism. Sem Perinatol. 1999 Apr;23(2):194-203
3. Strenger V, Kerbl R, Dornbusch HJ, et al: Diagnostic and prognostic impact of urinary catecholamines in neuroblastoma patients. Pediatr Blood Cancer. 2007 May;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 Jun;47(9):848-852
5. Matthay KK, Maris JM, Schleiermacher G, et al: Neuroblastoma. Nat Rev Dis Primers. 2016 Nov 10;2:16078. doi: 10.1038/nrdp.2016.78
Report Available
2 to 4 daysMethod Name
Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)
Forms
If not ordering electronically, complete, print, and send an Oncology Test Request (T729) with the specimen.
mml-biochemical