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Catecholamines, Fractionated, Plasma

Test Summary

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


Aliases

  • N/A

Specimen Collection

Special Instructions

N/A

Preferred Specimen

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

Minimum Volume

1 mL

Instructions

Draw specimen in a pre-chilled green-top vacutainer. After drawing specimen, place green-top tube in an ice bath. Centrifuge 20 minutes 1000xg. The plasma must be free of RBCs. Freeze on dry ice to transport.

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

N/A

Transport Temperature

Frozen

Specimen Stability

  • Room temperature: 6 hours
  • Refrigerated: 6 hours
  • Frozen: 30 days

Limitations

Recent surgery, traumatic injury, upright posture, cold, anxiety, pain, clonidine withdrawal, and concurrent acute or chronic illness may produce elevated results.

Other Acceptable Specimens

Frozen plasma collected in: EDTA (lavender-top) tube

Unacceptable Specimens

Received room temperature • Received refrigerated

Order Code

CATPL

EPIC (Premier) Code

LAB087

Includes

Dopamine, Epinephrine, Norepinephrine and Total Catecholamines (calculated)

CPT Code

  • 82384

Billing Code

  • 670632

CPT Statement

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

Catecholamines, Total (<18 years)Not established
  
Catecholamines, Total (≥18 years)
Epinephrine
  Supine<58 pg/mL
  Upright<82 pg/mL
  
Norepinephrine
  Supine149-564 pg/mL
  Upright199-937 pg/mL
  
Dopamine
  Supine<16 pg/mL
  Upright<27 pg/mL
  
Total Catecholamines
  Supine<632 pg/mL
  Upright<1046 pg/mL

Setup Schedule / Expected Turnaround Time

Monday - Saturday; Report available 2 - 4 days

Specimen Collection

Special Instructions

N/A

Preferred Specimen

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

Minimum Volume

1 mL

Instructions

Draw specimen in a pre-chilled green-top vacutainer. After drawing specimen, place green-top tube in an ice bath. Centrifuge 20 minutes 1000xg. The plasma must be free of RBCs. Freeze on dry ice to transport.

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

N/A

Transport Temperature

Frozen

Specimen Stability

  • Room temperature: 6 hours
  • Refrigerated: 6 hours
  • Frozen: 30 days

Limitations

Recent surgery, traumatic injury, upright posture, cold, anxiety, pain, clonidine withdrawal, and concurrent acute or chronic illness may produce elevated results.

Other Acceptable Specimens

Frozen plasma collected in: EDTA (lavender-top) tube

Unacceptable Specimens

Received room temperature • Received refrigerated

Billing

CPT Code

  • 82384

Billing Code

  • 670632

CPT Statement

CPT Statement

Result Information

Methodology

Liquid Chromatography/Mass Spectrometry (LC/MS)

Testing Laboratory

N/A

Reference Range

Catecholamines, Total (<18 years)Not established
  
Catecholamines, Total (≥18 years)
Epinephrine
  Supine<58 pg/mL
  Upright<82 pg/mL
  
Norepinephrine
  Supine149-564 pg/mL
  Upright199-937 pg/mL
  
Dopamine
  Supine<16 pg/mL
  Upright<27 pg/mL
  
Total Catecholamines
  Supine<632 pg/mL
  Upright<1046 pg/mL

Setup Schedule / Expected Turnaround Time

Monday - Saturday; Report available 2 - 4 days