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    Catecholamines - urine

    Dopamine-urine test; Epinephrine-urine test; Adrenalin-urine test; Vanillylmandelic acid (VMA); Urine metanephrine; Normetanephrine; Norepinephrine-urine test; Urine catecholamines; VMA; HVA; Metanephrine; Homovanillic acid (HVA)

    Catecholamines are small substances made by nerve tissue (including the brain) and the adrenal gland.

    The major catecholamines are dopamine, norepinephrine, and epinephrine. These substances break down into other substances, which leave your body through your urine.

    A urine test can be done to measure the level of catecholamines in your body.

    Catecholamines can also be measured with a blood test. See also: Catecholamines - blood

    How the Test is Performed

    For this test, you must urinate into a special bag or container every time you use the bathroom for 24-hour period.

    • On day 1, urinate over the toilet into the container or bag when you wake up in the morning. Close the container tightly. Keep it in the refrigerator or a cool place during the collection period.
    • Urinate into the special container every time you use the bathroom for the next 24 hours.
    • On day 2, urinate into the container in the morning again when you wake up.
    • Label the container with your name, the date, the time of completion, and return it as instructed.

    For an infant:

    Thoroughly wash the area around the urethra (the hole where urine flows out). Open a urine collection bag (a plastic bag with an adhesive paper on one end).

    • For males, place the entire penis in the bag and attach the adhesive to the skin.
    • For females, place the bag over the two folds of skin on either side of the vagina (labia). Put a diaper on the baby (over the bag).

    Check the infant frequently, and change the bag after the infant has urinated. Empty the urine from the bag into the container provided by your doctor.

    Because lively infants can cause the bag to move, this procedure may take a couple of attempts. You may need extra collection bags.

    When finished, label the container and return it as instructed.

    How to Prepare for the Test

    Stress and vigorous exercise may affect the test results.

    Foods that can increase urinary catecholamines include coffee, tea, bananas, chocolate, cocoa, citrus fruits, and vanilla. Avoid these foods for several days before the test.

    Certain drugs can also affect the test results. Your health care provider may tell you to stop taking certain medicines before the test. Never stop taking medicine without first talking to your doctor.

    The following drugs can increase catecholamine measurements:

    • Alcohol
    • Aminophylline
    • Amphetamines
    • Buspirone
    • Caffeine
    • Cocaine
    • Decongestants such as phenylephrine or pseudoephedrine
    • Drug withdrawal
    • Levodopa
    • Methyldopa
    • Phenothiazines
    • Reserpine
    • Tricyclic antidepressants

    Drugs that can decrease catecholamine measurements include:

    • Clonidine
    • Disulfiram
    • Guanethidine
    • MAO inhibitors
    • Salicylates

    How the Test Will Feel

    The test involves only normal urination, and there is no discomfort.

    Why the Test is Performed

    The test is usually done to diagnose an adrenal gland tumor called pheochromocytoma. It may also be used to diagnose neuroblastoma. Urine catecholamine levels are increased in most persons with neuroblastoma.

    The urine test for catecholamines may also be used to monitor those who are receiving treatment for these conditions.

    Normal Results

    All of the catecholamines are broken down into inactive substances that appear in the urine:

    • Dopamine becomes homovanillic acid (HVA)
    • Norepinephrine becomes normetanephrine and vanillylmandelic acid (VMA)
    • Epinephrine becomes metanephrine and VMA

    The following normal values are the amount of the substance found in the urine over a 24-hour period:

    • Dopamine: 65 - 400 micrograms (mcg)/24 hours
    • Epinephrine: 0.5 - 20 mcg/24 hours
    • Metanephrine: 24 - 96 mcg/24 hours (some laboratories give the range as 140 - 785 mcg/24-hours)
    • Norepinephrine: 15 - 80 mcg/24 hours
    • Normetanephrine: 75 - 375 mcg/24 hours
    • Total urine catecholamines: 14 - 110 mcg/24 hours
    • VMA: 2 - 7 milligrams (mg)/24 hours

    Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.

    The examples above show the common measurements for results for these tests. Some laboratories use different measurements or may test different specimens.

    What Abnormal Results Mean

    Elevated levels of urinary catecholamines may indicate:

    • Acute anxiety
    • Ganglioblastoma (very rare)
    • Ganglioneuroma (very rare)
    • Neuroblastoma (rare)
    • Pheochromocytoma (rare)
    • Severe stress

    The test may also be performed for:

    • Multiple endocrine neoplasia (MEN) II

    Risks

    There are no risks.

    Considerations

    Several foods and drugs, as well as physical activity and stress, can affect the accuracy of this test.

    References

    Young WF. Adrenal medulla, catecholamines, and pheochromocytoma. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 246.

    Young WF. Endocrine hypertension. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 16.

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    • Female urinary tract

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    • Male urinary tract

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    • Catecholamine urine test

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      • Female urinary tract

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      • Male urinary tract

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      • Catecholamine urine test

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            Tests for Catecholamines - urine

            Review Date: 6/1/2011

            Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

            The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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