Catecholamines Fractionated, Plasma (Epinephrine, Norepinephrine and Dopamine)


Sunquest Code:CATECH  
Epic Code:LAB3361Epic Name:Catecholamines Fractionated
Synonyms:Catecholamines, Free; Dopamine, Plasma; Epinephrine/Norepinephrine, Plasma
Methodology:High performance liquid chromatography
CPT Code:82384
Test Includes:Dopamine, Epinephrine, Norepinephrine
Turnaround Time:Specimens are sent to reference laboratory Mon-Sat; results are reported in 1-4 days.


Collection Instructions

Specimen:Blood
Optimal Volume:8 mL
Minimum\Peds Volume:4.4 mL
Container:Green (lithium heparin) on ICE (Green (sodium heparin, no gel) on ICE)
Collection Instructions:Collect two 3 mL or one 8.5 mL chilled green (lithium heparin) or green (sodium heparin, no gel) tube. Testing requires 2.1 mL minimum of plasma.

Chill the collection tubes before drawing sample; avoid hemolysis. Place tubes on ice and send to laboratory immediately.
Patient Preparation:
Patient should be calm and in a supine position for 30 minutes prior to collection. Medications which may interfere with catecholamines and metabolites include amphetamines and amphetamine-like compounds, appetite suppressants, bromocriptine, buspirone, caffeine, carbidopalevodopa (Sinemet), clonidine, dexamethasone, diuretics (in doses sufficient to deplete sodium), ethanol, isoproterenol, methyldopa (Aldomet), MAO inhibitors, nicotine, nose drops, propafenone (Rythmol), reserpine, theophylline, tricyclics and vasodialators. The effect of drugs on catecholamine results may not be predictable.  
Causes for Rejection:Not on ice, EDTA plasma, serum or urine specimens. Room temperature or refrigerated specimens.


Processing and Shipping

Specimen Processing:Separate plasma from cells within 1 hour. Centrifuge and aliquot 4 mL, 2.1 mL minimum. CRITICAL FROZEN. Separate specimens must be submitted when multiple tests are ordered. Store in freezer.
Shipping Instructions:Ship on dry ice.
Test Performed at or Referral Lab Lab Sendouts  (ARUP)
Referral Lab number:80216


Interpretive

Reference Range:

 

Age

Epinephrine

pg/mL

Norepinephrine

pg/mL

Dopamine

pg/mL

2-10 d

36-400

170-1180

0-20

11 d–3 mo

55-200

370-2080

0-20

4-11 mo

55-440

270-1120

0-20

1 y

36-640

68-1810

0-20

2 y

18-440

170-1470

0-20

3-17 y

18-460

85-1250

0-20

18 y and older

10-200

80-520

0-20

A reference range is not provided by reference laboratory for patients under 2 days of age.

 

Use:

Small increases in catecholamines (less than 2 times the upper reference limit) are usually the result of physiological stimuli, drugs, or improper specimen collection. Significant elevation of one or more catecholamines (2 or more the upper reference limit) is associated with an increased probability of a neuroendocrine tumor. Measurement of plasma or urine fractionated metanephrines provides better diagnostic sensitivity than measurement of catecholamines.

 

Additional causes of elevated catecholamines include improper collection of specimens, anxiety, intense physical activity and neuroendocrine tumors. Norepinephrine values up to 2000 pg/mL have been observed occasionally in patients with essential hypertension Conversely, normal plasma catecholamine values have been reported in some patients with pheochromocytoma. Therefore plasma catecholamine results should be supplemented with additional analytical data for the differential diagnosis of peochromocytoma/neuroblastoma 9e.g. clonidine suppression test, imaging studies, etc.)

 



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