vanillylmandelate (VMA) in 24 hour urine

Indications

• suspected neuroendocrine tumor
  • pheochromocytoma
  • neuroblastoma
  • ganglioneuroma

Reference interval

• adult: < 8 mg/day (< 40 umol/day)
• < 10 ug/mg (6 mmol/mol) of creatinine*

* Creatinine is measured simultaneously to ensure adequate collection of urine & to calculate VMA/creatinine ratio.

Increases

• pharmaceutical agents
  • in vivo effects
    • epinephrine, glucagon, guanethidine (initial doses), histamine, insulin (high doses), levodopa (small increase), lithium, nitroglycerin, reserpine (initial doses)
  • chemical interferences (colorimetric methods)
    • aminosalicylic acid, aspirin, labetolol, nalidixic acid, methyldopa, caffeine, guaiacol, methamine, mephenesin, methocarbamol, oxytetracycline, phenazopyridine
    • bananas, chocolate, tea, coffee, vanilla
• clinical disorders
  • pheochromocytoma
  • neuroblastoma
  • ganglioneuroma
  • carcinoid tumor (some cases)

Decreases

• pharmaceutical agents
  • in vivo effects
    • chlorpromazine, clonidine (dose-dependent), debrisoquine, disulfiram, guanethidine, hydrazine derivatives, imipramine, MAO inhibitors, morphine, radiographic agents, reserpine (chronic)
  • chemical interferences
    • alkaline urine (instable at room temp above pH of 3.0) aspirin, dihydroxyphenylacetic acid, gentisic acid, homovanillic acid (HVA), levodopa, clofibrate

Methods

• HPLC
• gas chromatography
• color (Pisano)

Specimen

• urine, 24 hours
• preserve with 20 mL of 6M HCl
• refrigerate
• stable for 2 weeks

More general terms

• 24 hour urine
• vanillylmandelate in urine

Additional terms

• carcinoid (argentaffinoma)
• ganglioneuroma
• neuroblastoma
• pheochromocytoma; paroxysmal hypertension; adrenal medullary paraganglioma; chromoffinoma
• vanillylmandelate

Patient information

vanillylmandelate (VMA) in 24 hour urine patient information