Vanillylmandelic Acid (VMA), Urine

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Subject: Vanillylmandelic Acid (VMA), Urine

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Definition

  • 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.

Use

  • Screening for catecholamine-secreting tumors in children when accompanied by HVA

  • Supporting a diagnosis of neuroblastoma

  • Monitoring neuroblastoma treatment

Interpretation

Increased In

  • Pheochromocytoma

  • Paraganglioma

  • Neuroblastoma

Limitations

  • 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.

 
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