ARUP's Laboratory Test Directory

0080470: Vanillylmandelic Acid (VMA) & Homovanillic Acid (HVA), Urine

Test Mnemonic: VH
Methodology: High Performance Liquid Chromatography

Performed: Sun, Tue-Sat

Reported: 1-3 days

Specimen Required:  
Collect: 24-hour or random urine. Refrigerate 24-hour sample during collection.

Transport: 5 mL aliquot from a well mixed 24-hour or random collection at 2-8°C.  (Min: 3 mL)  Submit specimen in an ARUP Standard Transport Tube. Record 24-hour total volume on tube.

Pediatric Collection/Transport: 1.5 mL aliquot at 2-8°C. Record 24-hour total volume on tube.

Remarks: Refrigeration is the preferred method of preservation. Record total volume and collection time interval on transport tube and test request form.

Stability: Ambient: Unacceptable; Refrigerated: 1 week; Frozen: 2 weeks

Reference Interval:
 
 
Components Reference Interval  
HVA, Urine 18 years and older 0.0-15.0 mg/d
VMA, Urine 18 years and older 0.0-7.0 mg/d
 The HVA-to-creatinine ration and VMA-to-creatinine ratio will be 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.  
HVA, Urine 0-2 years       
3-5 years
6-17 years
18 years and older 		0-42 mg/g crt
0-22 mg/g crt
0-15 mg/g crt
0-8 mg/g crt
VMA, Urine 0-2 years
3-5 years
6-17 years
18 years and older 		0-27 mg/g crt
0-13 mg/g crt
0-9 mg/g crt
0-6 mg/g crt
Creatinine (24-hour) 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:
Vanillylmandelic acid (VMA) and homovanillic acid (HVA) results are expressed as a ratio to creatinine excretion (mg/g cr). VMA and 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.



Note:
Moderately elevated HVA (homovanillic acid) and 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 predicable.

CPT Code(s):
83150 HVA; 84585 VMA

 

 

 
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