Catecholamines Fractionated, Plasma

Overview

  • EPIC Code:
  • LAB870
  • Soft Test Code:
  • CATFP
  • Send Out Test Code:
  • 314x (902446)
Alternate Names
  • Adrenaline
  • Catecholamines, Free
  • Dopamine
  • Epinephrine
  • Noradrenalin
  • Norepinephrine
Included Tests

 Catecholamines, Total (calculated); Dopamine; Epinephrine; Norepinephrine


Clinical Significance

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


Specimen Collection & Preparation

Test Notes:

Due to stress, plasma Catecholamine levels are generally unreliable in infants and small children. Urinary Catecholamine assays are more reliable.

Patient Preparation

Overnight Fasting preferred

Patient should avoid alcohol, coffee, tea, tobacco, and strenuous exercise before collection.


Specimen Overview

Order must include body position as supine or upright when drawing patient

Specimen Requirements:

-OR-

4.0 mL Plasma from a Green Top Tube - Na Heparin in a Plastic Vial
Minimum Volume:
2.0 mL Plasma*

* This volume does not allow for repeat testing

Collection Instructions:

  1. Pre-Chill tube before collection
  2. Patient should be relaxed in either a supine or upright position before blood is drawn.
  3. Perform regular phlebotomy with prechilled tube
  4. After drawing specimen, place green-top tube in ice bath. 


Processing Instructions:

  1. Remove from ice bath
  2. Centrifuge for 20 minutes 1000XG.
  3. The plasma "MUST" be free of RBCS,
  4. Transfer plasma to clean, plastic, screw-capped vial(s).
  5. Freeze specimen on dry ice to transport


Transport and Storage:
  • Ambient: 6 Hours
  • Refrigerated: 6 Hours
  • Frozen (-20 C or colder): 30 Days

    Transport on dry ice

Clinical Interpretation

Reference Range:

See Laboratory Report


Test Comments:

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


Methodology:
  • Electrochemical Detection
  • High Performance Liquid Chromatography (HPLC)

Clinical Significance

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


Production Schedule

Sites Performed
  • Quest - Chantilly to San Juan Capistrano
Days Performed
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Departments
  • Sendouts - Clinical
Turn Around Time

3 to 5 days


Coding & Compliance

CDM

01428709


CPT Coding

82384