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HelpTest Code CATU Catecholamine Fractionation, Free, 24 Hour, Urine
Reporting Name
Catecholamine Fract, Free, UUseful For
An auxiliary test to fractionated plasma and urine metanephrine measurements in the diagnosis of pheochromocytoma and paraganglioma
An auxiliary test to urine vanillylmandelic acid and homovanillic acid determination in the diagnosis and follow-up of patients with neuroblastoma and related tumors
This test is not useful as a first-line test for pheochromocytoma.
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
UrineOrdering Guidance
This assay is of greatest value when the specimen is collected during a hypertensive episode.
Do not perform the test on patients withdrawing from legal or illegal drugs known to cause rebound catecholamine release during withdrawal (see Cautions).
This test is not a first-line test for pheochromocytoma. The recommended first-line laboratory tests for pheochromocytoma are PMET / Metanephrines, Fractionated, Free, Plasma; and METAF / Metanephrines, Fractionated, 24 Hour, Urine.
Necessary Information
24-Hour volume (in milliliters) is required.
Specimen Required
Patient Preparation:
1. If medically feasible, discontinue drugs that release or hinder metabolism of epinephrine, norepinephrine, or dopamine for at least 1 week prior to specimen collection (see Cautions for details). If this is not possible for medical reasons, contact the laboratory to discuss whether a shorter drug-withdrawal period may be acceptable.
2. Unless the reason for testing is drug monitoring, the patient should stop any epinephrine, norepinephrine, or dopamine injections or infusions for at least 12 hours prior to specimen collection.
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container: Plastic vial
Specimen Volume: 2 mL
Collection Instructions:
1. Add 25 mL of 50% acetic acid as preservative at start of collection. Use 15 mL of 50% acetic acid for children younger than 5 years old. This preservative is intended to achieve a pH of between approximately 2 and 4.
2. Collect urine for 24 hours.
Additional Information: See Urine Preservatives-Collection and Transportation for 24-Hour Urine Specimens for multiple collections.
Specimen Minimum Volume
1.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Urine | Refrigerated (preferred) | 28 days | |
| Frozen | 28 days |
Special Instructions
Reference Values
Norepinephrine <1 year: <11 mcg/24 h
1 year: 1-17 mcg/24 h
2-3 years: 4-29 mcg/24 h
4-6 years: 8-45 mcg/24 h
7-9 years: 13-65 mcg/24 h
≥10 years: 15-80 mcg/24 h
Epinephrine
<1 year: <2.6 mcg/24 h
1 year: <3.6 mcg/24 h
2-3 years: <6.1 mcg/24 h
4-9 years: 0.2-10.0 mcg/24 h
10-15 years: 0.5-20.0 mcg/24 h
≥16 years: <21 mcg/24 h
Dopamine
<1 year: <86 mcg/24 h
1 year: 10-140 mcg/24 h
2-3 years: 40-260 mcg/24 h
≥4 years: 65-400 mcg/24 h
For International System of Units (SI) conversion for Reference Values, see www.mayocliniclabs.com/order-tests/si-unit-conversion.html.
Day(s) Performed
Monday through Saturday
Test 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
82384
Clinical Information
The catecholamines (dopamine, epinephrine, and norepinephrine) are derived from tyrosine via a series of enzymatic conversions. All 3 catecholamines are important neurotransmitters in the central nervous system and play crucial roles in the autonomic regulation of many homeostatic functions, namely vascular tone, intestinal and bronchial smooth muscle tone, cardiac rate and contractility, and glucose metabolism. Their actions are mediated via alpha- and beta-adrenergic receptors and dopamine receptors, all existing in several subforms. The 3 catecholamines overlap but also differ in their receptor activation profile and consequent biological actions.
The systemically circulating fraction of the catecholamines is derived almost exclusively from the adrenal medulla, with small contributions from sympathetic ganglia. They are normally present in the plasma in minute amounts, but levels can increase dramatically and rapidly in response to change in posture, environmental temperature, physical and emotional stress, hypovolemia, blood loss, hypotension, hypoglycemia, and exercise.
In patients with pheochromocytoma, a potentially curable tumor of catecholamine-producing cells of the adrenal medulla, or less commonly of sympathetic ganglia (paraganglioma), urine catecholamine levels may be elevated. This results in episodic or sustained hypertension and often in intermittent attacks of palpitations, cardiac arrhythmias, headache, sweating, pallor, anxiety, tremor, and nausea ("spells"). Elevations of the urine levels of 1 or several of the catecholamines may also be observed in patients with neuroblastoma and related tumors (ganglioneuroblastomas and ganglioneuromas) and, very occasionally, in other neuroectodermal tumors.
At the other end of the spectrum, inherited and acquired syndromes of autonomic dysfunction/failure and autonomic neuropathies are characterized by either inadequate production of 1 or several of the catecholamines or by insufficient release of catecholamines upon appropriate physiological stimuli (eg, change in posture from supine to standing, cold exposure, exercise, stress).
Report Available
2 to 5 daysReject Due To
All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.Method Name
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Forms
If not ordering electronically, complete, print, and send an Oncology Test Request (T729) with the specimen.