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HelpTest Code Billings Clinic: 4789 Mayo: VH Vanillylmandelic Acid and Homovanillic Acid, Random, Urine
Reporting Name
VMA and HVA, Random, UPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Useful For
Preferred first test for screening for catecholamine-secreting tumors in a random urine specimen when requesting both homovanillic acid and vanillylmandelic acid
Supporting a diagnosis of neuroblastoma
Monitoring patients with a treated neuroblastoma
Method Name
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Ordering Guidance
In the past, this test has been used to screen for pheochromocytoma. However, vanillylmandelic acid (VMA) is not the analyte of choice to rule out a diagnosis of pheochromocytoma. Recommended tests for that purpose include:
-PMET / Metanephrines, Fractionated, Free, Plasma
-METAF / Metanephrines, Fractionated, 24 Hour, Urine
-CATU / Catecholamine Fractionation, Free, 24 Hour, Urine
Necessary Information
1. Patient's age is required.
2. All patients receiving L-dopa should be identified to the laboratory when this test is ordered.
3. Bactrim may interfere with detection of the analyte. All patients taking Bactrim should be identified to the laboratory when this test is ordered.
Specimen Required
Patient Preparation: Administration of L-dopa may falsely increase homovanillic acid and vanillylmandelic acid results; it should be discontinued 24 hours prior to specimen collection.
Supplies: Urine Tubes, 10 mL (T068)
Collection Container/Tube: Clean, plastic urine collection container
Submission Container/Tube: Plastic, 10-mL urine tube
Specimen Volume: 5 mL
Collection Instructions:
1. Collect a random urine specimen.
2. Adjust the urine pH to a level between 1 and 5 by adding 50% acetic acid or hydrochloric acid dropwise and checking the pH.
Specimen Type
UrineSpecimen Minimum Volume
2 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Urine | Refrigerated (preferred) | 28 days | |
| Frozen | 180 days |
Reject Due To
All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.Reference Values
VANILLYLMANDELIC ACID
<1 year: <25.0 mg/g creatinine
1 year: <22.5 mg/g creatinine
2-4 years: <16.0 mg/g creatinine
5-9 years: <12.0 mg/g creatinine
10-14 years: <8.0 mg/g creatinine
≥15 years: <7.0 mg/g creatinine
HOMOVANILIC ACID
<1 year: <35.0 mg/g creatinine
1 year: <30.0 mg/g creatinine
2-4 years: <25.0 mg/g creatinine
5-9 years: <15.0 mg/g creatinine
10-14 years: <9.0 mg/g creatinine
≥15 years: <8.0 mg/g creatinine
Interpretation
Homovanillic acid (HVA) and vanillylmandelic acid (VMA) concentrations are elevated in more than 90% of patients with neuroblastoma; both tests should be performed. A positive test could be due to a genetic or nongenetic condition. Additional confirmatory testing is required.
A normal result does not exclude the presence of a catecholamine-secreting tumor.
Elevated HVA and VMA values are suggestive of a pheochromocytoma, but they are not diagnostic.
Day(s) Performed
Monday through Friday
Report Available
3 to 5 daysTest Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
83150-HVA
84585-VMA
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| VH | VMA and HVA, Random, U | 90250-2 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 2143 | Vanillylmandelic Acid, VH | 3124-5 |
| 2144 | Homovanillic Acid, VH | 11146-8 |
Forms
If not ordering electronically, complete, print, and send an Oncology Test Request (T729) with the specimen.