Homovanillic Acid

Label Mnemonic:	HVA24
Epic code:	LAB7450
Downtime form:	A-1a Doctor/Provider Orders - Pathology Core and Specialty Care Nursery

Commercial Mailout Laboratory
6240-8 RCP
356-8593

Specimen(s):

24 hr Urine More information

Specimen Instructions:

Refrigerate during 24 hr collection in plastic container; maintain refrigeration for submission. Refrigeration is the preferred method of preservation.

All four tests may be done on same collection.

Collection Medium:

Urine - 24 hour/timed plastic urine container

Minimum:

Preferred Minimum: 4 mL from a well-mixed 24 hr urine collection.
Absolute Minimum: 1 mL from a well-mixed 24 hr urine collection.

Abstain from medications for 72 hours prior to collection.

Rejection Criteria:

Specimens types other than urine.

Turn Around Time:

1-5 days upon receipt at reference laboratory

Reference Range:

Components          Age                  Ref. Interval

Homovanilla Acid    18 years and older   0.0-15.0 mg/d
  per 24 hr

Homovanillic Acid   The HVA-to-creatinine ratio will be 
  Ratio to CRT      reported when the patient is under 
                    18 years, the urine collection is random 
                    or other than 24 hours, or the urine
                    volume is less than 400 mL/24 hours.

Homovanillic Acid   0-2 years           0-42 mg/g CRT
  Ratio to CRT      3-5 years           0-22 mg/g CRT
                    6-17 years          0-15 mg/g CRT
                    18 years and older  0-8 mg/g CRT

Creatinine, Urine
  per 24 hr                    Male
                    3-8 years           140-700 mg/d
                    9-12 years          300-1300 mg/d
                    13-17 years         500-2300 mg/d
                    18-50 years         1000-2500 mg/d
                    51-80 years         800-2100 mg/d
                    81 years and older  600-2000 mg/d

                               Female
                    3-8 years           140-700 mg/d
                    9-12 years          300-1300 mg/d
                    13-17 years         400-1600 mg/d
                    18-50 years         700-1600 mg/d
                    51-80 years         500-1400 mg/d
                    81 years and older  400-1300 mg/d

Interpretive Data:

Homovanillic acid (HVA) results are expressed as a ratio to creatinine excretion (mg/g CRT). HVA mass per day (mg/d) is not reported on specimens from patients younger than 18 years of age, for random specimens, urine collection periods other than 24 hours, or for urine volumes less than 400 mL/d. No reference interval is available for results reported in units of mg/L.

Comments:

If screening for Neuroblastoma, the following tests are suggested: CAT24 (Catecholamines, Fractionated; Dopamine is included), HVA24 (Homovanillic Acid), MET24 (Metanephrines), VMA24 (Vanillylmandelic Acid).

Moderately elevated HVA (homovanillic acid) may be caused by a variety of factors such as essential hypertension, intense anxiety, intense physical exercise, and numerous drug interactions (including some over- the-counter medications and herbal products).

Medications that may interfere with catecholamines and their metabolites include amphetamines and amphetamine-like compounds, appetite suppressants, bromocriptine, buspirone, caffeine, chlorpromazine, clonidine, disulfiram, diuretics (in doses sufficient to deplete sodium), epinephrine, glucagon, guanethidine, histamine, hydrazine derivatives, imipramine, levodopa (L-dopa, Sinemet®), lithium, MAO inhibitors, melatonin, methyldopa (Aldomet®), morphine, nitroglycerin, nose drops, propafenone (Rythmol), radiographic agents, rauwolfia alkaloids (Reserpine), and vasodilators. The effects of some drugs on catecholamine metabolite results may not be predictable.

Methodology:

Quantitative High Performance Liquid Chromatography-Tandem Mass Spectrometry

CPT Code:

83150

See also:
Catecholamines, Fractionated, 24 hr Urine
Metanephrines Total, 24 hr Urine
Vanillylmandelic Acid, 24 hr Urine

See Additional Information:
Urine Tests Requiring Preservatives, Refrigeration or Special Containers