Homovanillic Acid
Label Mnemonic: HVA24
Epic Lab Code: LAB7450
Downtime Form: A-1a Miscellaneous Request
Commercial Mail-out Laboratory
5231 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:
1-4 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