Vanillylmandelic Acid

Label Mnemonic:	VMAUR
Epic code:	LAB7402
Downtime form:	Doctor/Provider Orders - Pathology Core and Specialty Care Nursery

Commercial Mailout Laboratory
6240-8 RCP
356-8593

Specimen(s):

Random Urine

Collection Medium:

Yellow top round bottom tube (no additive)

Minimum:

Preferred Minimum: 4 mL random urine
Absolute Minimum: 1 mL random urine
Abstain from medications for 72 hours prior to collection.

Turn Around Time:

1-5 days upon receipt at reference laboratory

Reference Range:

Components           Age                 Ref. Interval

Vanillylmandelic     18 years and older  0.0-7.0 mg/d
  Acid - per 24 hr

Vanillylmandelic     The VMA-to-creatinine ratio will be reported when 
  Acid - Ratio       the patient is under 18 years or the  urine volume
  to CRT             is less than 400 mL/24 hours.

Vanillylmandelic     0-2 years           0-27 mg/g CRT
  Acid - Ratio       3-5 years           0-13 mg/g CRT
  to CRT             6-17 years          0-9 mg/g CRT
                     18 years and older  0-6 mg/g CRT

Interpretive Data:

Vanillylmandelic acid (VMA) results are expressed as a ratio to creatinine excretion (mg/g cr). VMA 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:

Moderately elevated VMA (vanillylmandelic acid) can 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), tricyclic antidepressants, and vasodilators. The effects of some drugs on catecholamine metabolite results may not be predictable.

Methodology:

High Performance Liquid Chromatography - Tandem Mass Spectrometry

CPT Code:

84585

See also:
Catecholamines, Fractionated, Random Urine
Homovanillic Acid, Random Urine
Metanephrines Total, Random Urine

See Additional Information:
Urine Tests Requiring no Preservatives