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Test ID 3MT 3-Methoxytyramine, 24 Hour, Urine


Necessary Information


24-Hour volume (in milliliters) is required.



Specimen Required


Patient Preparation: Tricyclic antidepressants, labetalol, and sotalol medications may elevate levels of catecholamines producing results that cannot be interpreted. If clinically feasible, it is optimal to discontinue these medications at least 1 week before collection. Levodopa (Sinemet) medication will cause false-positive results. For advice on assessing the risk of removing patients from these medications and alternatives, consider consultation with a specialist in endocrinology or hypertension.

Supplies: Urine Tubes, 10 mL (T068)

Submission Container/Tube: Plastic urine tube

Specimen Volume: 10 mL

Collection Instructions:

1. Complete 24-hour urine collections are preferred, especially for patients with episodic hypertension; ideally the collection should begin at the onset of a "spell."

2. Add 10 g (pediatric: 3 g) of boric acid or 25 mL (pediatric: 15 mL) of 50% acetic acid as preservative at start of collection.

3. Collect urine for 24 hours.

Additional Information: See Urine Preservatives-Collection and Transportation for 24-Hour Urine Specimens for multiple collections.


Secondary ID

65157

Useful For

A first- and second-order screening test for the presumptive diagnosis of catecholamine-secreting pheochromocytomas and paragangliomas

 

Testing in conjunction or as an alternative to plasma metanephrines (PMET / Metanephrines, Fractionated, Free, Plasma) or plasma catecholamine (CATP / Catecholamine Fractionation, Free, Plasma) testing

Method Name

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

Reporting Name

3-Methoxytyramine, 24h, U

Specimen Type

Urine

Specimen Minimum Volume

3 mL

Specimen Stability Information

Specimen Type Temperature Time
Urine Refrigerated (preferred) 28 days
  Frozen  90 days
  Ambient  28 days

Clinical Information

Pheochromocytoma is a rare, though potentially lethal, tumor of chromaffin cells of the adrenal medulla that produces episodes of hypertension with palpitations, severe headaches, and sweating (spells). Patients with pheochromocytoma may also be asymptomatic and present with sustained hypertension or an incidentally discovered adrenal mass.

 

Pheochromocytomas and other tumors derived from neural crest cells (eg, paragangliomas and neuroblastomas) secrete catecholamines (epinephrine, norepinephrine, and dopamine). Dopamine secreting tumors are rarer than norepinephrine and epinephrine secreting tumors.

 

3-Methoxytyramine (3MT), metanephrine, and normetanephrine are the metabolites of dopamine, epinephrine, and norepinephrine, respectively. These metabolites are further metabolized to vanillylmandelic acid. Pheochromocytoma cells also have the ability to oxymethylate catecholamines into metanephrines that are secreted into circulation.

 

This test may be used as the first test for low-suspicion cases and as a confirmatory study in patients with less than a 2-fold elevation in plasma free fractionated catecholamines. This is highly desirable, as the very low population incidence rate of pheochromocytoma (<1:100,000 population per year) will otherwise result in large numbers of unnecessary, costly, and sometimes risky imaging procedures.

Reference Values

Males: ≤306 mcg/24 hours

Females: ≤242 mcg/24 hours

Cautions

This test utilizes a liquid chromatography/tandem mass spectrometry (LC-MS/MS) method and is not affected by the interfering substances that affected older spectrophotometric (Pisano reaction) methods (ie, diatrizoate, chlorpromazine, hydrazine derivatives, imipramine, monoamine oxidase [MAO] inhibitors, methyldopa, phenacetin, ephedrine, or epinephrine) or acetaminophen in high-performance liquid chromatography (HPLC) methods.

 

This method is not subject to the known interference of acetaminophen (seen with the plasma metanephrine HPLC-electrochemical detection method).

Day(s) Performed

Monday through Friday

Report Available

3 to 5 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

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

CPT Code Information

82542

NY State Approved

Yes

Urine Preservative Collection Options

Note: The addition of preservative must occur prior to beginning the collection.

Ambient (no additive)

OK

Refrigerate (no additive)

OK

Frozen (no additive)

OK

50% Acetic Acid

Preferred

Boric Acid

Preferred

Diazolidinyl Urea

No

6M Hydrochloric Acid

OK

6M Nitric Acid

OK

Sodium Carbonate

OK

Thymol

No

Toluene

OK