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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
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 ​4 mL ​2 mL
Collection Processing Instructions

1. Collect a random urine specimen.
2. pH adjustment not necessary if specimen will arrive at testing lab (Mayo Medical Laboratories) within 6 days of collection.
3. If specimen will not arrive at testing lab within 6 days from collection, 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)

Specimen Stability Information
Specimen Type Temperature Time
​Urine ​ ​Refrigerate (preferred) ​28 days
​Frozen ​180 days
Interference
​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.
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
​Mayo Clinic Laboratories ​Monday through Friday, 8 am ​2 days ​SPE methodology;  Analysis by Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)
Reference Lab
Mayo Clinic Laboratories
Test Information
This test was developed and its performance characteristics determined by Mayo Clinic Laboratories.
 
​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
This test was developed and its performance characteristics determined by Mayo Clinic Laboratories.
​
Synonyms/Keywords
​HVA (Homovanillic Acid)
Neuroblastoma Profile
Ordering Applications
Ordering Application Description
​Centricity ​Homovanillic Acid (HVA), Random Urine (HVAR)
​Cerner ​Homovanillic Acid (HVA), Random Urine (HVAR)
​COM ​Homovanillic Acid (HVA), Random Urine (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 ​4 mL ​2 mL
Collection Processing

1. Collect a random urine specimen.
2. pH adjustment not necessary if specimen will arrive at testing lab (Mayo Medical Laboratories) within 6 days of collection.
3. If specimen will not arrive at testing lab within 6 days from collection, 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)

Specimen Stability Information
Specimen Type Temperature Time
​Urine ​ ​Refrigerate (preferred) ​28 days
​Frozen ​180 days
Interference
​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.
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, 8 am ​2 days ​SPE methodology;  Analysis by 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
This test was developed and its performance characteristics determined by Mayo Clinic Laboratories.
​
For most current information refer to the Marshfield Laboratory online reference manual.