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Test Directory Dopamine, Plasma

Dopamine, Plasma

Test Summary

Measurement of dopamine levels in urine or blood in addition to urinary vanillylmandelic acid (VMA) and homovanillic acid (HVA) levels may aid in the biochemical diagnosis and monitoring of neuroblastomas [1]. This test may also be useful in evaluating dopamine-secreting pheochromocytomas and paragangliomas (PPGLs) [2].

Neuroblastomas occur predominantly in children and are the most common malignancy under 1 year old. Neuroblastomas are catecholamine-metabolizing tumors, and thus catecholamine metabolites (including VMA and HVA) are more reliable than catecholamines as biochemical markers for neuroblastomas [1]. However, urinary VMA and HVA levels may have limited accuracy for diagnosis of neuroblastomas with high-risk metastatic biology [1]. Because poor prognosis is associated with immaturity of catecholamine metabolism, dopamine levels in urine or blood have been proposed as an additional marker to aid in diagnosis and monitoring of neuroblastomas [3].

Most PPGLs secrete catecholamines, but the relative amount of dopamine, norepinephrine, and epinephrine varies widely. Measurements of plasma free or urinary fractionated metanephrines (ie, the O-methylated catecholamine metabolites) are recommended by the Endocrine Society for the initial biochemical testing of PPGLs [4]. In patients with high clinical suspicion but normal blood pressure and normal levels of metanephrines, measurement of dopamine and its metabolites (HVA and methoxytyramine) may help diagnose PPGLs that predominantly secrete dopamine [2].

The results of this test should be interpreted in the context of pertinent clinical and family history and physical examination findings.

References
1. Eisenhofer G. Monoamine-producing tumors. In: Rifai R, et al. eds. Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier Inc; 2022.
2. Jain A, et al. Pediatr Nephrol. 2020;35(4):581-594.
3. Brodeur GM, et al. J Clin Oncol. 1993;11(8):1466-1477.
4. Lenders JW, et al. J Clin Endocrinol Metab. 2014;99(6):1915-1942

Aliases

Specimen Collection

Special Instructions

N/A

Preferred Specimen

2 mL plasma collected in a sodium heparin (green-top) tube - See instructions

Minimum Volume

1 mL

Instructions

Draw specimen in a pre-chilled green-top vacutainer. Plasma should be separated in a refrigerated centrifuge within 30 minutes of collection and then frozen immediately at -20°C in plastic vials. Each specimen will be invoiced separately.

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.
Patient should avoid alcohol, coffee, tea, tobacco and strenuous exercise prior to collection. Overnight fasting is preferred.

Storage

Plastic screw-cap vials

Transport Temperature

Frozen

Specimen Stability

Room temperature: 6 hours
Refrigerated: 6 hours
Frozen: 31 days

Limitations

N/A

Other Acceptable Specimens

Plasma collected in an EDTA (lavender-top) tube - See instructions

Unacceptable Specimens

Gross hemolysis

Order Code

DOPA

EPIC (Premier) Code

LAB6325

Includes

N/A

CPT Code

82542

Billing Code

670258

CPT Statement

Methodology

Liquid Chromatography/Mass Spectrometry (LC/MS)

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. The FDA has determined that such clearance or approval is not necessary. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes.

Physician Attestation of Informed Consent

N/A

Testing Laboratory

Quest Diagnostics Nichols Institute
33608 Ortega Highway
San Juan Capistrano CA, 92675

Department

Reference Testing

Reference Range

Dopamine, Plasma

<18 years	No Reference Range Available
≥18 years	Supine: <16 pg/mL Upright: <27 pg/mL

Setup Schedule / Expected Turnaround Time

Monday - Friday; Report available: 4 - 7 days