Ordering Guidance

In the past, this test has been used to screen for pheochromocytoma. However, vanillylmandelic acid (VMA) is not the analyte of choice to rule out a diagnosis of pheochromocytoma. Recommended tests for that purpose include:

-PMET / Metanephrines, Fractionated, Free, Plasma

-METAF / Metanephrines, Fractionated, 24 Hour, Urine

-CATU / Catecholamine Fractionation, Free, 24 Hour, Urine

Necessary Information

1. Patient’s age is required.

2. Collection duration (in hours) and urine volume (in milliliters) are required.

3. All patients receiving L-dopa should be identified to the laboratory when this test is ordered.

4. Bactrim may interfere with detection of the analyte. All patients taking Bactrim should be identified to the laboratory when this test is ordered.

Specimen Required

Patient Preparation: Administration of L-dopa may falsely increase vanillylmandelic acid results. For 24 hours prior to specimen collection, the patient should not take L-dopa.

Supplies: Urine Tubes, 10 mL (T068)

Collection Container/Tube: Clean, plastic urine collection container

Submission Container/Tube: Plastic, 10-mL urine tube

Specimen Volume: 5 mL

Collection Instructions:

1. Add 25 mL of 50% acetic acid as preservative at the start of collection. Use 15 mL of 50% acetic acid for children younger than 5 years. If specimen is refrigerated during collection, preservative may be added up to 12 hours after collection. This preservative is intended to achieve a pH of between approximately 1 and 5.

2. Collect a 24-hour urine specimen.

3. If necessary, adjust urine pH to a level between 1 and 5 by adding 50% acetic acid or hydrochloric acid dropwise and checking the pH.

Additional Information: For multiple collections see Urine Preservatives-Collection and Transportation for 24-Hour Urine Specimens.