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Test ID HVA Homovanillic Acid (HVA), 24 Hour, Urine

Useful For

Screening children for catecholamine-secreting tumors with a 24-hour urine collection when requesting homovanillic acid only

 

Monitoring neuroblastoma treatment

 

Screening patients with possible inborn errors of catecholamine metabolism

Method Name

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

Reporting Name

Homovanillic Acid (HVA), 24 Hr, U

Specimen Type

Urine

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

Specimen Volume: 5 mL

Collection Instructions:

1. Collect a 24-hour urine specimen.

2. Add 25 mL of 50% acetic acid as preservative at start of collection. If specimen is refrigerated during collection, preservative may be added up to 12 hours after collection. Use 15 mL of 50% acetic acid for children <5 years old. This preservative is intended to achieve a pH of between approximately 1 and 5. If necessary, adjust urine pH to 1 to 5 with 50% acetic or HCI acid.

Additional Information:

1. Patient's age and 24-hour volume are required.

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

3. The sensitivity of this test is greater on a 24-hour specimen than on a random specimen.

4. See Urine Preservatives in Special Instructions for multiple collections.

5. Bactrim may interfere with detection of the analyte. All patients taking Bactrim should be identified to the laboratory when this test is ordered.

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)

 

Urine Preservative Collection Options

Ambient

No

Refrigerated

No

Frozen

No

6N HCl

Yes

50% Acetic Acid

Preferred

Na2CO3

No

Toluene

No

6N HNO3

No

Boric Acid

No

Thymol

No

Specimen Minimum Volume

2 mL

Specimen Stability Information

Specimen Type Temperature Time
Urine Refrigerated (preferred) 7 days
  Frozen  7 days

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; monamine 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.

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 mg/24 hours

Cautions

Administration of L-dopa may falsely increase homovanillic acid (HVA) results. Patients receiving L-dopa should stop taking it for 24 hours before and during the collection.

 

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

 

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.

Day(s) Performed

Monday through Friday; 8 a.m.

.

Report Available

2 days (not reported on Sunday)

Performing Laboratory

Mayo Medical Laboratories in Rochester

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

83150

NY State Approved

Yes