Test Details

• Discipline:

  Biochemistry

  Biochemistry

• Specimen Container Adult:

  24 urine collection: a 24 hour urine collected into a container with sand and sulphuric acid preservative.
  Overnight urine collection: an overnight urine collection into a container with sand and su...

  24 urine collection: a 24 hour urine collected into a container with sand and sulphuric acid preservative.
  Overnight urine collection: an overnight urine collection into a container with sand and sulphuric acid preservative.
  Random urine collection: white universal container  [Send to laboratory immediately].

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• Specimen Container Paediatric:

  Random urine collection: white universal container [Send to laboratory immediately].

  Random urine collection: white universal container [Send to laboratory immediately].

• Minimum Volume Adult:

  1 - 10 mL urine

  1 - 10 mL urine

• Minimum Volume Paediatric:

  1 - 10 mL urine

  1 - 10 mL urine

• Special Requirement:

  Random samples have limited stability, send to lab immediately.

  Urine metanephrines are used for the diagnosis of phaeochromocytoma. To test for neuroblastoma - measure urine HMMA and HVA (neurobla...

  Random samples have limited stability, send to lab immediately.

  Urine metanephrines are used for the diagnosis of phaeochromocytoma. To test for neuroblastoma - measure urine HMMA and HVA (neuroblastoma screen).

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• Sample Stability:

  Urine samples are stable at 4°C for up to 6 weeks. For longer periods store at –15°C.

  Urine samples are stable at 4°C for up to 6 weeks. For longer periods store at –15°C.

• Transport Requirements:

  Ambient temperature

  Ambient temperature

• Quality Assurance:

  UK National External Quality Assurance Scheme (NEQAS) for Urinary Catecholamines

  UK National External Quality Assurance Scheme (NEQAS) for Urinary Catecholamines

• Interpretation:

  Urine metanephrine or normetanephrine values greater than 4 times the upper reference interval are highly suggestive of the presence of phaeochromocytoma/paraganglioma. Elevated results are reporte...

  Urine metanephrine or normetanephrine values greater than 4 times the upper reference interval are highly suggestive of the presence of phaeochromocytoma/paraganglioma. Elevated results are reported with appropriate comments.

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• Reference Ranges:

  24-hour Metanephrine (µmol/24hr):

  0 - 9m: 0 – 0.2
  9 - 12m: 0 – 0.5
  1 - 2y: 0 – 0.3
  2 - 6y: 0.1 – 0.5
  6-10y: 0.3 – 0.7 

  10-16y: 0.2 – 1.2

  Adult (female): 0 – 1.8

  Adult (male): 0 - 2.2

   

  24-hour ...

  24-hour Metanephrine (µmol/24hr):

  0 - 9m: 0 – 0.2
  9 - 12m: 0 – 0.5
  1 - 2y: 0 – 0.3
  2 - 6y: 0.1 – 0.5
  6-10y: 0.3 – 0.7 

  10-16y: 0.2 – 1.2

  Adult (female): 0 – 1.8

  Adult (male): 0 - 2.2

   

  24-hour Normetanephrine (µmol/24hr):

  0 - 9m: 0.2 – 0.8
  9 - 12m: 0.1 – 0.6
  1 - 2y: 0.2 – 0.6
  2 - 6y: 0.3 – 0.6
  6-10y: 0.3 – 1.0 

  10-16y: 0.3 – 1.6

  Adult (female): 0 - 3.0

  Adult (male): 0 – 3.8

   

  24-hour 3-methoxytyramine (µmol/24hr):

  0 - 9m: N/A
  9 - 12m: N/A
  1 - 2y: N/A 
  2 - 6y: N/A 
  6-10y: N/A 

  10-16y: N/A

  Adult (female): 0 - 2.8

  Adult (male): 0 - 2.8

   

  Overnight / Random Metanephrine (­µmol/mmol creatinine):
  0 - 9m: 0.12 - 0.41
  9 - 12m: 0.08 - 0.37
  1 - 2y: 0.02 - 0.30
  2 - 6y: 0.04 - 0.29
  6-10y: 0.07 - 0.18 

  10-16y: 0 – 0.18

  Adult (female): 0 – 0.3

  Adult (male): 0 – 0.3

   

  Overnight / Random Normetanephrine (µmol/mmol creatinine):
  0 - 9m: 0.94 - 2.07
  9 - 12m: 0.16 - 0.68
  1 - 2y: 0.22 - 0.79
  2 - 6y: 0.06 - 0.37
  6 - 10y: 0.06 - 0.28
  10 - 16y: 0 - 0.25
  Adult (female): 0 - 0.35 

  Adult (male): 0 - 0.35 

  
  

  Overnight / Random 3-methoxytyramine (µmol/mmol creatinine):

  0 - 9m: N/A
  9 - 12m: N/A
  1 - 2y: N/A 
  2 - 6y: N/A 
  6-10y: N/A 

  10-16y: N/A

  Adult (female): 0 - 0.22

  Adult (male): 0 - 0.22

  
  

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• Factors Affecting Result:

  Drugs can interfere analytically or pharmacodynamically with measurement of plasma or urinary metanephrines, potentially causing false positive results. Analytical interference is more likely to af...

  Drugs can interfere analytically or pharmacodynamically with measurement of plasma or urinary metanephrines, potentially causing false positive results. Analytical interference is more likely to affect the urine metanephrine HPLC-ECD assay. The LC-MS/MS method for plasma free metanephrines is considered to be far less susceptible to analytical interference.

  Many drugs are now known to increase catecholamine and metabolite concentrations, including tricyclic antideppressant's, selective serotonin reuptake inhibitors, serotonin and noradrenaline reuptake inhibitors, α- and β- adrenergic receptor blockers, calcium channel blockers, monoamine oxidase inhibitors, Levo(L)-Dopa, methyldopa and several stimulant/sympathomimetic drugs.

  Ideally patients should discontinue all medications that may affect plasma and urinary catecholamine or metanephrine concentrations prior to sampling. In practice, it is not always possible to discontinue medication before testing and it might be better to repeat testing only when initial tests are elevated.

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• Routine Contact Name:

  Duty Biochemist

• Routine Telephone:

  Freeman: 0191 244 8889
  RVI: 0191 282 9719

  Freeman: 0191 244 8889
  RVI: 0191 282 9719

• Routine Email:

  nuth.dutybiochemist@nhs.net

• Specialist Test:

  Yes

  Yes