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Subject: Vanillylmandelic Acid (VMA), Urine
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Major metabolite of catecholamine, historically has been used to screen pheochromocytoma. The current recommended test now is fractionated plasma free metanephrines.
Other names: 3-methoxy-4-hydroxymandelic acid and 4-hydroxy-3- methoxymandelic acid.
Normal range: 0–7 mg/day.
Screening for catecholamine-secreting tumors in children when accompanied by HVA
Supporting a diagnosis of neuroblastoma
Monitoring neuroblastoma treatment
Patients should avoid salicylates, caffeine, phenothiazine, and antihypertension agents, as well as coffee, tea, chocolate, and fruit (especially bananas and any vanilla-containing substances for 72 hours prior to collection).
Some neuroblastoma patients are positive for urinary homovanillic acid abnormality but do not excrete increased VMA. Twenty to thirty-two percent of patients with neuroblastoma do not have elevation of VMA. Many have other laboratory abnormalities such as increased metanephrines, HVA, or dopamine.