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Vanillylmandelic Acid (VMA), Random Urine

CPT 82570; 84585
Synonyms
  • 3-Methoxy-4-Hydroxymandelic Acid
  • VMA, Random Urine

Test Details

Methodology

Liquid chromatography/tandem mass spectrometry (LC/MS-MS)

Result Turnaround Time

4 - 7 days

Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.

Test Includes

Creatinine, urine; VMA, urine (mg/L); VMA:creatinine ratio

Use

Pediatric testing for the evaluation of hypertension; diagnose and follow up neuroblastoma, ganglioneuroma, and ganglioneuroblastoma. Most neuroblastoma patients excrete excess HVA in 24-hour collections. If VMA and HVA are both used in work-up, up to 80% of all cases will be detected.

Special Instructions

Use for patients where 24-hour urine collection is difficult (eg, pediatric patients). Twenty-four-hour urine collection is preferable (see Vanillylmandelic Acid (VMA), 24-Hour Urine [004143]).

Limitations

This test was developed and its performance characteristics determined by LabCorp. It has not been cleared or approved by the Food and Drug Administration.

Footnotes

1. Soldin SJ, Hill JG. Liquid chromatographic analysis for urinary 4-hydroxy-3-methoxymandelic acid and 4-hydroxy-3-mehoozyphenylacetic acid and Its use in investigation of neural crest tumors. Clin Chem. 1981; 27(3):502-503. 7471405

References

Bio-Rad VMA. Package insert. October 1989.
Kaplan LA, Pesce AJ. Clinical Chemistry, Theory, Analysis, and Correlation. St Louis, Mo: CV Mosby Co;1989.

Custom Additional Information

Some neuroblastoma patients are positive for urinary homovanillic acid abnormality but do not excrete increased VMA. Twenty percent to 32% of patients with neuroblastoma do not have elevation of VMA. Many will have other laboratory abnormalities such as increased metanephrines, homovanillic acid (HVA), or dopamine.

Specimen Requirements

Specimen

Urine

Volume

10 mL aliquot

Minimum Volume

1 mL aliquot

Container

Plastic urine container

Collection Instructions

If specimen is to be stored for longer than seven days before analysis, use random urine transport tube.

Stability Requirements

Temperature

Period

Room temperature

7 days

Refrigerated

14 days

Frozen

14 days

Freeze/thaw cycles

Stable x3

Reference Range

Pediatric patients1 and adults: VMA:creatinine ratio

• Up to 2 years: 0.0−18.8 mg/g creatinine

• 2 to 4 years: 0.0−11.0 mg/g creatinine

• 5 to 9 years: 0.0−8.3 mg/g creatinine

• 10 to 19 years: 0.0−8.2 mg/g creatinine

• Older than 19 years: 0.0−6.0 mg/g creatinine

Storage Instructions

Vanillylmandelic acid is stable at room temperature unpreserved for seven days.

Patient Preparation

Patient should avoid salicylates, caffeine, phenothiazine, and antihypertension agents. Also coffee, tea, chocolate, fruit (especially bananas and any vanilla-containing substances for 72 hours prior to collection).

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
123208 VMA, Random Urine 070016 Creatinine, Random U mg/dL 2161-8
123208 VMA, Random Urine 123209 VMA, Random Urine mg/L 9624-8
123208 VMA, Random Urine 070050 VMA/Crt, Random U mg/g Creat 3124-5
Order Code123208
Order Code NameVMA, Random Urine
Order Loinc
Result Code070016
Result Code NameCreatinine, Random U
UofMmg/dL
Result LOINC2161-8
Order Code123208
Order Code NameVMA, Random Urine
Order Loinc
Result Code123209
Result Code NameVMA, Random Urine
UofMmg/L
Result LOINC9624-8
Order Code123208
Order Code NameVMA, Random Urine
Order Loinc
Result Code070050
Result Code NameVMA/Crt, Random U
UofMmg/g Creat
Result LOINC3124-5