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Test ID VMAR Vanillylmandelic Acid, Random, Urine


Ordering Guidance


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 this purpose are:

-PMET / Metanephrines, Fractionated, Free, Plasma

-METAF / Metanephrines, Fractionated, 24 Hour, Urine

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



Necessary 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 vanillylmandelic acid results; it should be discontinued 24 hours prior to specimen collection.

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


Secondary ID

60274

Useful For

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

 

Supporting a diagnosis of neuroblastoma

 

Monitoring patients with a treated neuroblastoma

Method Name

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

Reporting Name

Vanillylmandelic Acid, Random, U

Specimen Type

Urine

Specimen Minimum Volume

2 mL

Specimen Stability Information

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

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.

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

Cautions

Values are more commonly elevated during a hypertensive episode.

 

Values may be normal in some individuals with a pheochromocytoma.

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

84585

NY State Approved

Yes