Catecholamines, Fractionated
Label Mnemonic: | CAT24 |
Epic code: | LAB7452 |
Downtime form: | Doctor/Provider Orders - Pathology Core and Specialty Care Nursery |
Commercial Mailout Laboratory
6240-8 RCP
356-8593
6240-8 RCP
356-8593
Specimen(s):
24 hr Urine More information
Specimen
Instructions:
Refrigerate during 24 hr collection in plastic container. Adequate
refrigeration is the most important aspect of specimen
preservation.
Abstain from medications for 72 hours prior to collection.
All five tests may be done on same collection.
Abstain from medications for 72 hours prior to collection.
All five tests may be done on same collection.
Minimum:
Preferred Minimum: 4 mL from a well-mixed 24 hr urine collection.
Absolute Minimum: 2.5 mL from a well-mixed 24 hr urine collection.
Record total volume and collection time interval on transport container and test request form.
Absolute Minimum: 2.5 mL from a well-mixed 24 hr urine collection.
Record total volume and collection time interval on transport container and test request form.
Rejection Criteria:
Specimens preserved with boric acid or acetic acid. Specimens with pH greater than 7.
Turn Around
Time:
1-5 days upon receipt at reference laboratory
Reference Range:
Reference Intervals for 24-Hour Calculations (24-Hour Urine)
Reference Intervals for Ratio-to-Creatinine (CRT) Calculations (Random Urine)
Components Reference Interval Dopamine 0-3 years Not Established 4-10 years 80-440 μg/d 11-17 years 100-496 μg/d 18 years and older 71-485 μg/d Epinephrine 0-3 years Not Established 4-10 years 1-14 μg/d 11-17 years 1-18 μg/d 18 years and older 1-14 μg/d Norepinephrine 0-3 years Not Established 4-10 years 7-65 μg/d 11-17 years 12-96 μg/d 18 years and older 14-120 μg/d Creatinine (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
Reference Intervals for Ratio-to-Creatinine (CRT) Calculations (Random Urine)
Dopamine 0-11 months 240-1290 μg/g crt 1-3 years 80-1220 μg/g crt 4-10 years 220-720 μg/g crt 11-17 years 120-450 μg/g crt 18 years and older 0-250 μg/g crt Epinephrine 0-11 months 0-380 μg/g crt 1-3 years 0-82 μg/g crt 4-10 years 5-93 μg/g crt 11-17 years 3-58 μg/g crt 18 years and older 0-20 μg/g crt Norepinephrine 0-11 months 25-310 μg/g crt 1-3 years 25-290 μg/g crt 4-10 years 27-110 μg/g crt 11-17 years 4-105 μg/g crt 18 years and older 0-45 μg/g crt
Interpretive Data:
The optimal specimen for this testing is a 24-hour urine collection.
Mass per day calculations are not reported for patients younger than 18 years of age and for the following specimen types: a random collection, a collection with duration of less than 20 hours, a collection with duration of greater than 28 hours, or a collection with total volume less than 400 mL. Ratios to creatinine may be useful for these evaluations.
Smaller increases in catecholamine concentrations (less than two times the upper limit) usually are the result of physiological stimuli, drugs, or improper specimen collection. Significant elevation of one or more catecholamines (three or more times the upper reference limit) is associated with an increased probability of a neuroendocrine tumor.
Smaller increases in catecholamine concentrations (less than two times the upper limit) usually are the result of physiological stimuli, drugs, or improper specimen collection. Significant elevation of one or more catecholamines (three or more times the upper reference limit) is associated with an increased probability of a neuroendocrine tumor.
Comments:
Secreting neuroendocrine tumors are typically associated with
catecholamine concentrations several times higher than the upper
reference intervals. Large elevations can be seen in life-threatening
illnesses and drug interferences. Common reasons for slight and
moderate elevations include intense physical activity, emotional and
physical stress, drug interferences, and improper specimen
collection.
Medications which may physiologically interfere with catecholamines and metabolites include amphetamines and amphetamine-like compounds, appetite suppressants, bromocriptine, buspirone, caffeine, carbidopa- levodopa (Sinemet®), clonidine, dexamethasone, diuretics (in doses sufficient to deplete sodium), ethanol, isoproterenol, methyldopa (Aldomet®), MAO inhibitors, nicotine, nose drops, propafenone (Rythmol), reserpine, theophylline, tricyclic antidepressants, and vasodilators. The effects of some drugs on catecholamine results may not be predictable.
VMA, Catecholamines and Metanephrines may be done on same collection. Alpha methylodopa (Aldomet) and Labetalol (Normodyne) will falsely elevate the apparent concentration of urine catecholamines. Collection containers available from pharmacy.
Includes: Epidenphrine, Norepinephrine and Dopamine.
If screening for Neuroblastoma, the following tests are suggested: CAT24 (Catecholamines, Fractionated; Dopamine is included), HVA24 (Homovanillic Acid), MET24 (Metanephrines), VMA24 (Vanillylmandelic Acid).
Medications which may physiologically interfere with catecholamines and metabolites include amphetamines and amphetamine-like compounds, appetite suppressants, bromocriptine, buspirone, caffeine, carbidopa- levodopa (Sinemet®), clonidine, dexamethasone, diuretics (in doses sufficient to deplete sodium), ethanol, isoproterenol, methyldopa (Aldomet®), MAO inhibitors, nicotine, nose drops, propafenone (Rythmol), reserpine, theophylline, tricyclic antidepressants, and vasodilators. The effects of some drugs on catecholamine results may not be predictable.
VMA, Catecholamines and Metanephrines may be done on same collection. Alpha methylodopa (Aldomet) and Labetalol (Normodyne) will falsely elevate the apparent concentration of urine catecholamines. Collection containers available from pharmacy.
Includes: Epidenphrine, Norepinephrine and Dopamine.
If screening for Neuroblastoma, the following tests are suggested: CAT24 (Catecholamines, Fractionated; Dopamine is included), HVA24 (Homovanillic Acid), MET24 (Metanephrines), VMA24 (Vanillylmandelic Acid).
Methodology:
Quantitative High Performance Liquid Chromatography-Tandem Mass
Spectrometry
CPT Code:
82384
See also:
Homovanillic Acid, 24 hr Urine
Metanephrines Total, 24 hr Urine
Vanillylmandelic Acid, 24 hr Urine
Homovanillic Acid, 24 hr Urine
Metanephrines Total, 24 hr Urine
Vanillylmandelic Acid, 24 hr Urine
See Additional Information:
Urine Tests Requiring Preservatives, Refrigeration or Special Containers
Urine Tests Requiring Preservatives, Refrigeration or Special Containers