Download Catecholamines, Fractionated, Random Urine

Catecholamines, Fractionated,
Random Urine
Reference Range
E
N
μg/g creat μg/g creat
Birth to 6 mo
2-45
12-286
7-11 mo
5-45
19-250
1-2 y
1-49
25-210
3-8 y
4-32
20-108
9-12 y
1-15
20-73
13-17 y
1-10
15-58
Adults
2-16
7-65
Total N+E
D
μg/g creat μg/g creat
Birth to 6 mo
24-322 107-2180
7-11 mo
10-295
96-2441
1-2 y
30-263
86-1861
3-8 y
30-130 295-1123
9-12 y
25-90
164-744
13-17 y
20-70
156-551
Adults
9-74
40-390
mg/dL
2-32
2-36
2-128
2-149
2-183
Method
• HPLC, electrochemical detection
• Analytical sensitivity: 2 μg/L for
epinephrine and norepinephrine;
10 μg/L for dopamine
• Creatinine concentration also
reported
20-370
20-320
Specimen Requirements
10 mL room temperature urine
4 mL minimum
Add 25 mL of 6N HCl to maintain a
pH below 3.
E, epinephrine; N, norephinephrine;
D, dopamine.
Interpretive Information
• Pheochromocytoma
• Neuroblastoma
• Paragangliomas
• Stress
It is preferable for the patient to be off
medications for 3 d prior to collection;
however, common antihypertensives
cause minimal or no interference.
Patient should avoid alcohol, coffee,
tea, tobacco, and strenuous exercise
prior to collection.
45
Alphabetical Test
Section
Clinical Background
Catecholamines are synthesized in
chromaffin cells of the sympathetic
nervous system: epinephrine by the
adrenal medulla, and norepinephrine
and dopamine by the adrenal medulla
and postganglionic sympathetic
neurons. Catecholamines are excreted
in urine both intact and as metabolites
(metanephrines and vanillylmandelic
acid).
Elevated urinary catecholamine
concentrations are detected in the
majority of patients with pheochromocytoma. In patients with paroxysmal
symptoms or hypertension, the
sensitivity of testing can be increased
by beginning urine collection
immediately following an episode.
The pattern of catecholamine
secretion differs among tumor types:
pheochromocytomas generally
produce both norepinephrine and
epinephrine; paragangliomas secrete
norepinephrine; and neuroblastomas
produce excessive dopamine.
Clinical Use
• Diagnose catecholamine-secreting
tumors
Creatinine
0-6 mo
7-11 mo
1-2 y
3-8 y
9-12 y
>12 y
Males
Females
5244X