Catecholamines, Fractionated

Label Mnemonic:	CATP
Epic code:	LAB2807
Downtime form:	A-1a Doctor/Provider Orders - Pathology Core and Specialty Care Nursery

Commercial Mailout Laboratory
6240-8 RCP
356-8593

Specimen(s):

Plasma

Specimen Instructions:

Plasma must be separated from cells as soon as possible, within one hour of collection.

Collection Medium:

Green top tube 10 mL (Na Heparin) Hospital Stores #907693

Minimum:

Preferred Minimum: 4 mL plasma
Absolute Minimum: 2.1 mL plasma
Patient should be calm and supine for 30 minutes pre-collection.

Rejection Criteria:

EDTA plasma, serum or urine. Full 4 mL Green top Tube (Na Heparin) is NOT acceptable. Minimum specimen volume is not provided with this tube size and the order will be canceled.

Delivery Instructions:

After collection, place in wet ice and immediately deliver to laboratory. Critical Frozen.

Turn Around Time:

1-4 days upon receipt at reference laboratory

Reference Range:

Epinephrine
2-10 days          36-400 pg/mL
11 days-3 months   55-200 pg/mL
4-11 months        55-440 pg/mL
12-23 months       36-640 pg/mL
24-35 months       18-440 pg/mL
3-17 years         18-460 pg/mL
18 years and older 10-200 pg/mL

Norepinephrine
2-10 days           170-1180 pg/m
11 days-3 months    370-2080 pg/m
4-11 months         270-1120 pg/mL
12-23 months        68-1810 pg/mL
24-35 months        170-1470 pg/mL
3-17 years          85-1250 pg/m
18 years and older  80-520 pg/mL

Dopamine
2 days and older:   0-20 pg/mL

Interpretive Data:

Small increases in catecholamines (less than 2 times the upper reference limit) are usually the result of physiological stimuli, drugs, or improper specimen collection. Significant elevation of one or more catecholamines (2 or more times the upper reference limit) is associated with an increased probability of a neuroendocrine tumor. Measurement of plasma or urine fractionated metanephrines provides better diagnostic sensitivity than measurement of catecholamines.

Comments:

Medications which may 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, labetalol, methyldopa (Aldomet), MAO inhibitors, nicotine, nose drops, propafenone (Rythmol), reserpine, theophylline, tricyclic antidepressants, and vasodilators. The effects of drugs on catecholamine results may not be predictable.

For optimum results, patient should be supine for 30 minutes prior to collection. "Upright" ranges show epinephrine up to 900 pg/mL, and norepinephrine up to 700 pg/mL.

Children, particularly those under 2 years of age, often show an elevated catecholamine response to stress.

Methodology:

Quantitative High Performance Liquid Chromatography

CPT Code:

82384

See Additional Information:
Specimens Requiring Immediate Delivery