| A B C D E F G H I J K L M N O P Q R S T U V W X Y Z # |
Catecholamines, Fractionated, Plasma [314X]
Test CodeAlias/See Also
LAB870
CPT Codes
<p>82384</p>
Includes
Preferred Specimen
Patient Preparation: Patients should be relaxed in either a supine or upright position before blood is drawn. States of anxiety and stress can cause fluctuations in the catecholamine levels. Draw specimen in a pre-chilled green-top vacutainer. Patient should avoid alcohol, coffee, tea, tobacco and strenuous exercise prior to collection. Overnight fasting is preferred.
Specimen Type: Plasma
Collection Container/Type
Preferred: Green top (Sodium heparin)
Acceptable: Green top (Lithium heparin)
Submission Container/Tube: Plastic vial
Specimen Volume: 4 mL
Collection Instructions:
- After drawing specimen, place green-top tube in ice bath.
- Centrifuge 20 minutes 1000xg.
- The plasma must be free of RBCs. Freeze on dry ice to transport.
- FROZEN ONLY. DO NOT THAW.
Patient Preparation
Patients should be relaxed in either a supine or upright position before blood is drawn. States of anxiety and stress can cause fluctuations in the catecholamine levels. Draw specimen in a pre-chilled green-top vacutainer. Patient should avoid alcohol, coffee, tea, tobacco and strenuous exercise prior to collection. Overnight fasting is preferred.
Minimum Volume
2.5 mL
Other Acceptable Specimens
Instructions
Transport Temperature
Specimen Stability
Room temperature: 6 hours
Refrigerated: 6 hours
Frozen: 30 days
Methodology
High Performance Liquid Chromatography (HPLC) • Electrochemical Detection
This test was developed and its analytical performance characteristics have been determined by Quest Diagnostics. It has not been cleared or approved by the U.S. Food and Drug Administration. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes.
FDA Status
This test was developed and its analytical performance characteristics have been determined by Quest Diagnostics. It has not been cleared or approved by the U.S. Food and Drug Administration. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes.
Setup Schedule
Report Available
3-5 days
Limitations
Recent surgery, traumatic injury, upright posture, cold, anxiety, pain, clonidine withdrawal, and concurrent acute or chronic illness may produce elevated results.
Reference Range
| Catecholamines, Total (<18 years) | Not established |
| Catecholamines, Total (≥18 years) | |
| Epinephrine | |
| Supine | <58 pg/mL |
| Upright | <82 pg/mL |
| Norepinephrine | |
| Supine | 149-564 pg/mL |
| Upright | 199-937 pg/mL |
| Dopamine | |
| Supine | <16 pg/mL |
| Upright | <27 pg/mL |
| Total Catecholamines | |
| Supine | <632 pg/mL |
| Upright | <1046 pg/mL |
Clinical Significance
This panel may aid in evaluating catecholamine-producing pheochromocytomas and paragangliomas (PPGLs). However, measurements of plasma free or urinary fractionated metanephrines (ie, the O-methylated catecholamine metabolites) are preferred for the initial biochemical evaluation of PPGLs because of their overall high diagnostic sensitivity [1].
Most PPGLs secrete catecholamines and can cause catecholamine excess, resulting in hypertension, arrhythmia, and hyperglycemia. Left untreated, PPGLs often lead to life-threatening cardiovascular complications. The estimated prevalence of PPGLs is 0.05% to 0.1% in adults with hypertension and 1.7% in children with hypertension [2]. Recognizing the possibility of a PPGL and performing appropriate biochemical testing are crucial for the diagnosis [1]. Plasma or urine catecholamine levels may be used, in addition to metanephrine levels, to provide additional information during the initial biochemical evaluation of PPGLs (eg, when detecting dopamine-secreting paragangliomas) [2].
Intermittent or insignificant secretion of catecholamines by some PPGLs may not increase catecholamine measurements. Physiological stress and certain medications (eg, acetaminophen, labetalol, and sotalol) may increase catecholamine measurements [1].
The results of this test should be interpreted in the context of pertinent clinical and family history and physical examination findings.
References
1. Lenders JW, et al. J Clin Endocrinol Metab. 2014;99(6):1915-1942.
2. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology (NCCN Guidelines®). Neuroendocrine and Adrenal Tumors. V1.2022. Accessed June 28, 2022. http://www.nccn.org
Performing Laboratory
Quest Diagnostics Nichols Institute-San Juan Capistrano, CA
33608 Ortega Highway
San Juan Capistrano, CA 92675-2042
Last Updated: February 20, 2023