Test Details
Methodology
Liquid chromatography/tandem mass spectrometry (LC/MS-MS)
Result Turnaround Time
5 - 9 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
Urinary epinephrine; urinary norepinephrine; urinary dopamine; creatinine
Use
Work up neuroblastoma; diagnose pheochromocytoma. Pheochromocytomas and occasional paragangliomas may cause persistent or paroxysmal hypertension. Work up palpitation, severe headache, diaphoresis. Evaluate for possible multiple endocrine adenomatosis type II.
Special Instructions
Random urine collection. Note: If original container is received with pH >3, but <5, adjust pH to <3 with 6N HCl.
Limitations
False-negatives and false-positives occur. Since a 24-hour urine collection represents a longer sampling time than a random, or symptom-directed serum sample, and because catecholamine secretion by pheochromocytomas is intermittent, the 24-hour urine test may detect some cases missed by a blood or random urine level.
This test was developed and its performance characteristics determined by LabCorp. It has not been cleared or approved by the Food and Drug Administration.
Custom Additional Information
The expression “free” in free catecholamine fractionation means unconjugated. This assay is of most value for pheochromocytoma when specimen is collected during a hypertensive episode.
Specimen Requirements
Specimen
Urine (random)
Volume
10 mL aliquot
Minimum Volume
4 mL aliquot
Container
Use random urine transport tube containing 6N HCl or urine Monovette® with pH stabilizer (LabCorp N° 56015). Monovette® instructions accompany units. Preservative must be added to the container prior to the start of the collection. If collecting without Monovette®, use plastic urine container and adjust urine pH to <5 with 6N HCI. Caution: Strong acid. May cause skin burns.
Collection Instructions
Refer to the Preservative Quick Reference Chart in Specimen Collection: Urine Specimens.
Stability Requirements
Temperature | Period |
|---|---|
Room temperature | 3 days |
Refrigerated | 14 days |
Frozen | 30 days at 70°C |
Reference Range
Pediatric3 and adults:
• Epinephrine:
− 0 to 9 years: 0−37 μg/g creatinine
− 10 to 19 years: 0−17 μg/g creatinine
− >19 years: 0−19 μg/g creatinine
• Norepinephrine:
− 0 to 9 years: 0−150 μg/g creatinine
− 10 to 19 years: 0−67 μg/g creatinine
− >19 years: 0−111 μg/g creatinine
• Dopamine:
− 0 to 9 years: <1488 μg/g creatinine
− 10 to 19 years: <354 μg/g creatinine
− >19 years: <348 μg/g creatinine
Storage Instructions
Refrigerate
Patient Preparation
Avoid patient stress. Many drugs (reserpine and alpha methyldopa, levodopa, monoamine oxidase inhibitors, and sympathomimetic amines) may interfere and should be discontinued two weeks prior to specimen collection. Nose drops, sinus and cough medicines, bronchodilators and appetite suppressants, α2-agonists, calcium channel blockers, converting enzyme inhibitors, bromocriptine, phenothiazine, tricyclic antidepressants, α- and β-blockers, and labetalol may interfere.1 Mandelamine® interferes, but thiazides do not. Caffeine products should be avoided before and during collection. The patient should not be subjected to hypoglycemia or exertion. Increased intracranial pressure and clonidine withdrawal can cause false-positive results.1,2
Causes for Rejection
Specimen with no preservative; original container with pH >5
Footnotes
LOINC® Map
| Order Code | Order Code Name | Order Loinc | Result Code | Result Code Name | UofM | Result LOINC |
|---|---|---|---|---|---|---|
| 316203 | Catecholamines,Ur.,Free,Random | 92938-0 | 070016 | Creatinine, Random U | mg/dL | 2161-8 |
| 316203 | Catecholamines,Ur.,Free,Random | 92938-0 | 004193 | Epinephrine, Urine | ug/L | 11046-0 |
| 316203 | Catecholamines,Ur.,Free,Random | 92938-0 | 070025 | Epinephrine | ug/g Creat | 13734-9 |
| 316203 | Catecholamines,Ur.,Free,Random | 92938-0 | 004201 | Norepinephrine, Ur | ug/L | 2667-4 |
| 316203 | Catecholamines,Ur.,Free,Random | 92938-0 | 070026 | Norepinephrine | ug/g Creat | 13782-8 |
| 316203 | Catecholamines,Ur.,Free,Random | 92938-0 | 004203 | Dopamine, Urine | ug/L | 2217-8 |
| 316203 | Catecholamines,Ur.,Free,Random | 92938-0 | 070027 | Dopamine | ug/g Creat | 13733-1 |
| Order Code | 316203 | |||||
| Order Code Name | Catecholamines,Ur.,Free,Random | |||||
| Order Loinc | 92938-0 | |||||
| Result Code | 070016 | |||||
| Result Code Name | Creatinine, Random U | |||||
| UofM | mg/dL | |||||
| Result LOINC | 2161-8 | |||||
| Order Code | 316203 | |||||
| Order Code Name | Catecholamines,Ur.,Free,Random | |||||
| Order Loinc | 92938-0 | |||||
| Result Code | 004193 | |||||
| Result Code Name | Epinephrine, Urine | |||||
| UofM | ug/L | |||||
| Result LOINC | 11046-0 | |||||
| Order Code | 316203 | |||||
| Order Code Name | Catecholamines,Ur.,Free,Random | |||||
| Order Loinc | 92938-0 | |||||
| Result Code | 070025 | |||||
| Result Code Name | Epinephrine | |||||
| UofM | ug/g Creat | |||||
| Result LOINC | 13734-9 | |||||
| Order Code | 316203 | |||||
| Order Code Name | Catecholamines,Ur.,Free,Random | |||||
| Order Loinc | 92938-0 | |||||
| Result Code | 004201 | |||||
| Result Code Name | Norepinephrine, Ur | |||||
| UofM | ug/L | |||||
| Result LOINC | 2667-4 | |||||
| Order Code | 316203 | |||||
| Order Code Name | Catecholamines,Ur.,Free,Random | |||||
| Order Loinc | 92938-0 | |||||
| Result Code | 070026 | |||||
| Result Code Name | Norepinephrine | |||||
| UofM | ug/g Creat | |||||
| Result LOINC | 13782-8 | |||||
| Order Code | 316203 | |||||
| Order Code Name | Catecholamines,Ur.,Free,Random | |||||
| Order Loinc | 92938-0 | |||||
| Result Code | 004203 | |||||
| Result Code Name | Dopamine, Urine | |||||
| UofM | ug/L | |||||
| Result LOINC | 2217-8 | |||||
| Order Code | 316203 | |||||
| Order Code Name | Catecholamines,Ur.,Free,Random | |||||
| Order Loinc | 92938-0 | |||||
| Result Code | 070027 | |||||
| Result Code Name | Dopamine | |||||
| UofM | ug/g Creat | |||||
| Result LOINC | 13733-1 |