82120:CATECHOLAMINES, FRACTIONATED FREE

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82120:CATECHOLAMINES, FRACTIONATED FREE
Alias Names: Free Catecholamines / Adrenalin / Dopamine / Epinephrine / Noradrenaline
Methodology: High Performance Liquid Chromatography (HPLC)
Edit Date: 6/11/2010
Performed: Sunday, Tuesday-Saturday
Released: 24-72 hours after setup at PeaceHealth Laboratories’ reference lab.
CPT Code: 82384-90
Specimen Collection Details
Collection: Three 4 mL green top tubes (heparin). For optimum results, patient should be calm and in supine position for 30 minutes prior to collection. “Upright” ranges typically show norepinephrine up to 700 pg/mL, epinephrine up to 900 pg/mL, and dopamine essentially unchanged.
Handling: Chill specimen in ice water immediately after collection. Centrifuge and separate plasma from cells within 1 hour. Freeze. If multiple tests are ordered send separate specimen for this test.
Stability: Specimen stable 48 hours refrigerated, 1 month frozen at -20° C, or up to 1 year frozen at -70° C. Specimen unstable ambient.
Standard Volume: 4 mL plasma.
Minimum Volume: 2.1 mL plasma.
Transport: Frozen on dry ice.
Comments: Medications which may interfere with catecholamines and metabolites include amphetamines and amphetamine-like compounds, appetite suppressants, bromocriptine, buspirone, caffeine, carbidopa-levodopa (Sinemet®), clonidine, dexamethasone, diuretics (in doses sufficient to deplete sodium), ethanol, isoproterenol, labetalol, methyldopa (Aldomet®), MAO inhibitors, nicotine, nose drops, propafenone (Rythmol), reserpine, theophylline, tricyclic antidepressants, and vasodilators. The effects of drugs on catecholamine results may not be predictable.

Children, particularly those under 2 years of age, often show an elevated catecholamine response to stress.

Rejection Criteria: Ambient specimen; specimen not spun within 1 hour; urine, serum, or EDTA plasma.

Reference Range:
Components Age Interval
Epinephrine 2-10 days 36-400 pg/mL
11 days-3 months 55-200 pg/mL
4-11 months 55-440 pg/mL
12-23 months 36-640 pg/mL
24-35 months 18-440 pg/mL
3-17 years 18-460 pg/mL
≥18 years 10-200 pg/mL
Norepinephrine 2-10 days 170-1180 pg/mL
11 days-3 months 370-2080 pg/mL
4-11 months 270-1120 pg/mL
12-23 months 68-1810 pg/mL
24-35 months 170-1470 pg/mL
3-17 years 85-1250 pg/mL
≥18 years 80-520 pg/mL
Dopamine ≥2-days 0-20 pg/mL
Small increases in catecholamines (less than 2 times the upper reference limit) usually are the result of physiological stimuli, drugs, or improper specimen collection. Significant elevation of one or more catecholamines (2 or more times the upper reference limit) is associated with an increased probability of a neuroendocrine tumor. Measurement of plasma or urine fractionated metanephrines provides better diagnostic sensitivity than measurement of catecholamines.

PeaceHealth Laboratories