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26140 Homovanillic Acid (HVA), Random Urine (HVAR)

Homovanillic Acid (HVA), Random Urine (HVAR)
Test Code: HVARSO
Synonyms/Keywords

HVA (Homovanillic Acid)
Neuroblastoma Profile

Homovanillic Acid Rnd U (HVAR)

Homovanillic Acid, Random, Urine

U HVARSO

Useful For

Screening children for catecholamine-secreting tumors with a random urine collection when requesting homovanillic acid only

Monitoring neuroblastoma treatment

Screening patients with possible inborn errors of catecholamine metabolism

Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
​No ​Urine ​Urine Plastic Container ​ ​5 mL ​2 mL ​2 mL
Collection Processing Instructions

1. Collect a random urine specimen.

2. Adjust the random urine pH to a level between 1 and 5 by adding 50% acetic acid dropwise and checking the pH. (Special Chemistry department staff will adjust pH prior to sending to Mayo.

3. Patient's age is required.

4. All patients receiving L-dopa should be identified to Mayo Clinic Laboratories when this test is ordered.

5. Bactrim may interfere with detection of the analyte. All patients taking Bactrim should be identified to Mayo Clinic Laboratories when this test is ordered.

Specimen Stability Information
Specimen Type Temperature Time
​Urine ​ ​Refrigerate (preferred) ​28 days
​Frozen ​180 days
Interference

Administration of L-dopa may falsely increase homovanillic acid (HVA) results. Patients receiving L-dopa should stop taking it for 24 hours before and during the collection.

All patients receiving L-dopa should be identified to the laboratory when vanillylmandelic acid (VMA) and HVA tests are ordered.

Bactrim may interfere with detection of the analyte. All patients taking Bactrim should be identified to the laboratory when VMA and HVA tests are ordered.

Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
​Mayo Clinic Laboratories ​Monday through Friday ​2-4 days Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)
Reference Lab
Mayo Clinic Laboratories
Test Information

Homovanillic acid (HVA) and other catecholamine metabolites (vanillylmandelic acid: VMA and dopamine) are typically elevated in patients with catecholamine-secreting tumors (eg, neuroblastoma, pheochromocytoma, and other neural crest tumors). HVA and VMA levels may also be useful in monitoring patients who have been treated as a result of the above-mentioned tumors. HVA levels may also be altered in disorders of catecholamine metabolism; monoamine oxidase-A deficiency can cause decreased urinary HVA values, while a deficiency of dopamine beta-hydrolase (the enzyme that converts dopamine to norepinephrine) can cause elevated urinary HVA values.

Reference Range Information
Performing Location Reference Range
​Mayo Clinic Laboratories

<1 year: <35.0 mg/g creatinine

1 year: <30.0 mg/g creatinine

2-4 years: <25.0 mg/g creatinine

5-9 years: <15.0 mg/g creatinine

10-14 years: <9.0 mg/g creatinine

> or =15 years (adults): <8.0 mg/g creatinine

Interpretation

Vanillylmandelic acid and/or homovanillic acid (HVA) concentrations are elevated in over 90% of patients with neuroblastoma; both tests should be performed. A positive test could be due to a genetic or nongenetic condition. Additional confirmatory testing is required.

A normal result does not exclude the presence of a catecholamine-secreting tumor.

Elevated HVA values are suggestive of a deficiency of dopamine beta-hydrolase, a neuroblastoma, a pheochromocytoma, or may reflect administration of L-dopa.

Decreased urinary HVA values may suggest monoamine oxidase-A deficiency.

 
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
​83150 ​ ​1 ​ ​
Classification

 

Synonyms/Keywords

HVA (Homovanillic Acid)
Neuroblastoma Profile

Homovanillic Acid Rnd U (HVAR)

Homovanillic Acid, Random, Urine

U HVARSO

Ordering Applications
Ordering Application Description
​COM​Vanillylmandelic Acid (VMA), Random Urine (VMAR)
​Cerner Homovanillic Acid Rnd U (HVAR)
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
​No ​Urine ​Urine Plastic Container ​ ​5 mL ​2 mL ​2 mL
Collection Processing

1. Collect a random urine specimen.

2. Adjust the random urine pH to a level between 1 and 5 by adding 50% acetic acid dropwise and checking the pH. (Special Chemistry department staff will adjust pH prior to sending to Mayo.

3. Patient's age is required.

4. All patients receiving L-dopa should be identified to Mayo Clinic Laboratories when this test is ordered.

5. Bactrim may interfere with detection of the analyte. All patients taking Bactrim should be identified to Mayo Clinic Laboratories when this test is ordered.

Specimen Stability Information
Specimen Type Temperature Time
​Urine ​ ​Refrigerate (preferred) ​28 days
​Frozen ​180 days
Interference

Administration of L-dopa may falsely increase homovanillic acid (HVA) results. Patients receiving L-dopa should stop taking it for 24 hours before and during the collection.

All patients receiving L-dopa should be identified to the laboratory when vanillylmandelic acid (VMA) and HVA tests are ordered.

Bactrim may interfere with detection of the analyte. All patients taking Bactrim should be identified to the laboratory when VMA and HVA tests are ordered.

Useful For

Screening children for catecholamine-secreting tumors with a random urine collection when requesting homovanillic acid only

Monitoring neuroblastoma treatment

Screening patients with possible inborn errors of catecholamine metabolism

Reference Range Information
Performing Location Reference Range
​Mayo Clinic Laboratories

<1 year: <35.0 mg/g creatinine

1 year: <30.0 mg/g creatinine

2-4 years: <25.0 mg/g creatinine

5-9 years: <15.0 mg/g creatinine

10-14 years: <9.0 mg/g creatinine

> or =15 years (adults): <8.0 mg/g creatinine

Interpretation

Vanillylmandelic acid and/or homovanillic acid (HVA) concentrations are elevated in over 90% of patients with neuroblastoma; both tests should be performed. A positive test could be due to a genetic or nongenetic condition. Additional confirmatory testing is required.

A normal result does not exclude the presence of a catecholamine-secreting tumor.

Elevated HVA values are suggestive of a deficiency of dopamine beta-hydrolase, a neuroblastoma, a pheochromocytoma, or may reflect administration of L-dopa.

Decreased urinary HVA values may suggest monoamine oxidase-A deficiency.

 
For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
​Mayo Clinic Laboratories ​Monday through Friday ​2-4 days Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)
Reference Lab
Mayo Clinic Laboratories
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
​83150 ​ ​1 ​ ​
Classification

 

For most current information refer to the Marshfield Laboratory online reference manual.