Vanillylmandelic Acid (VMA), Random Urine

CPT: 82570; 84585
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Test Details

Synonyms

  • 3-Methoxy-4-Hydroxymandelic Acid
  • VMA, Random Urine

Test Includes

Creatinine, urine; VMA, urine (mg/L); VMA:creatinine ratio

Use

Pediatric testing for the evaluation of hypertension; diagnose and follow up neuroblastoma, ganglioneuroma, and ganglioneuroblastoma. Most neuroblastoma patients excrete excess HVA in 24-hour collections. If VMA and HVA are both used in work-up, up to 80% of all cases will be detected.

Methodology

Liquid chromatography/tandem mass spectrometry (LC/MS-MS)

Reference Interval

Pediatric patients1 and adults: VMA:creatinine ratio

• Up to 2 years: 0.0−18.8 mg/g creatinine

• 2 to 4 years: 0.0−11.0 mg/g creatinine

• 5 to 9 years: 0.0−8.3 mg/g creatinine

• 10 to 19 years: 0.0−8.2 mg/g creatinine

• Older than 19 years: 0.0−6.0 mg/g creatinine

Additional Information

Some neuroblastoma patients are positive for urinary homovanillic acid abnormality but do not excrete increased VMA. Twenty percent to 32% of patients with neuroblastoma do not have elevation of VMA. Many will have other laboratory abnormalities such as increased metanephrines, homovanillic acid (HVA), or dopamine.

Specimen Requirements

Specimen

Urine

Volume

10 mL aliquot

Minimum Volume

1 mL aliquot

Container

Plastic urine container

Patient Preparation

Patient should avoid salicylates, caffeine, phenothiazine, and antihypertension agents. Also coffee, tea, chocolate, fruit (especially bananas and any vanilla-containing substances for 72 hours prior to collection).

Collection

If specimen is to be stored for longer than seven days before analysis, use random urine transport tube.

Storage Instructions

Vanillylmandelic acid is stable at room temperature (15°C to 30°C) unpreserved for seven days.

Stability Requirements

Temperature

Period

Room temperature

7 days

Refrigerated

14 days

Frozen

14 days

Freeze/thaw cycles

Stable x3

Clinical Information

Special Instructions

Use for patients where 24-hour urine collection is difficult (eg, pediatric patients). Twenty-four-hour urine collection is preferable (see Vanillylmandelic Acid (VMA), 24-Hour Urine [004143]).

Footnotes

1. Soldin SJ, Hill JG. Liquid chromatographic analysis for urinary 4-hydroxy-3-methoxymandelic acid and 4-hydroxy-3-mehoozyphenylacetic acid and Its use in investigation of neural crest tumors. Clin Chem. 1981; 27(3):502-503. 7471405

References

Bio-Rad VMA. Package insert. October 1989.
Kaplan LA, Pesce AJ. Clinical Chemistry, Theory, Analysis, and Correlation. St Louis, Mo: CV Mosby Co;1989.

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
123208 VMA, Random Urine 070016 Creatinine, Random U mg/dL 2161-8
123208 VMA, Random Urine 123209 VMA, Random Urine mg/L 9624-8
123208 VMA, Random Urine 070050 VMA/Crt, Random U mg/g Creat 3124-5

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