Catecholamine Fractionation, Urinary, Free (Sendout)

General Information

Lab Name
Catecholamine Fract, Free, URN
Lab Code
RUFCAT
Epic Name
Catecholamine Fractionation, Free, Urine (Sendout)
External Test Id
CATU
Description

***Unless this test is ordered in conjunction with Metanephrines, Fractionated, 24-Hour, Urine (Sendout) [RUFMET], requests for this test should be discussed with the Lab Medicine resident on-call (206) 598-6190.*** Either plasma free metanephrines Metanephrines, Fractionated, Free, Plasma [RPLMET] or 24-h urine metanephrines Metanephrines, Fractionated, 24-Hour, Urine (Sendout) [RUFMET] offer superior performance for diagnosis of pheochromocytoma. The most sensitive test is plasma free metanephrines Metanephrines, Fractionated, Free, Plasma [RPLMET]; the most specific test is 24-h urine metanephrines Metanephrines, Fractionated, 24-Hour, Urine (Sendout) [RUFMET].

  • Note: Resident approval is expected for orders from within the teaching environment of UW Medicine (includes UW-MT, HMC, UWNC) but is not expected for outside clients of the reference laboratory, nor for physicians on the "Preauthorized Physicians" list.

Ordering Notes:

  1. This assay is of greatest value when the specimen is collected during a hypertensive episode.
  2. Discontinue any epinephrine, norepinephrine or dopamine injections/infusions at least 12 hours before specimen collection, unless drug monitoring is the goal*.
  3. Discontinue drugs that release or hinder metabolism of epinephrine, norepinephrine, or dopamine for at least 1 week before obtaining the specimen*.
  4. Do not perform the test on patients withdrawing from legal or illegal drugs known to cause rebound plasma catecholamine release during withdrawal.
    • *For advice on assessing the risk of removing patients from these medications and alternatives, consider consultation with a specialist in endocrinology or hypertension.
References

For a recent review of the biochemical diagnosis of pheochromocytoma, see Pacak K et al. Nature Clin Pract Endocrinol Metab 2007; 3:92-102.PMID: 17237836.

Synonyms
Adrenaline-Urine, CATU, Dopamine-Urine, Epinephrine-Urine, Noradrenaline-Urine, Norepinephrine-Urine, Pressor Amines-Urine, T008
Components

Interpretation

Method

Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)

Reference Range
See individual components
References

For a recent review of the biochemical diagnosis of pheochromocytoma, see Pacak K et al. Nature Clin Pract Endocrinol Metab 2007; 3:92-102.PMID: 17237836.

Ordering & Collection

Specimen Type
Urine
Collection

24 Hour Urine:

  1. Add 25 mL of 50% Acetic Acid as preservative in 24-hour urine container at the start of collection. This preservative is intended to achieve a pH of between approximately 2 and 4. Use 15 mL of 50% acetic acid for children less than 5 years old.
  2. Collect urine for 24 hours. Record the start date/time and end date/time on the requisition or on the collection container. Samples with collection intervals less than 22 hours or greater than 26 hours will be rejected by Mayo.

Unacceptable: Random urine, or urine with collection intervals <22 hrs or >26 hrs.

Mayo Preservative Supply: 50% Acetic Acid, 25 mL [T008]

Approval Required
LMR Approval required for orders from within the university system if not ordered concurrently with 24-hr urine metanephrines (RUFMET).
Handling Instructions

Outside Laboratories:

  • Mix urine. Measure the total volume and record it on the requisition.
  • Ensure that the pH falls within between approximately 2 and 4.
  • Transfer 10 mL urine to a screw-capped plastic vial and refrigerate.

Stability: Refrigerated (preferred): 7 days; Frozen: 14 days; Ambient: 7 days.

All specimens will be evaluated at Mayo Clinic Laboratories for test suitability. Random urine samples or timed collections <22 hours or >26 hours are not acceptable for testing.

Quantity
Requested: 10 mL urine
Minimum: 2 mL urine

Processing

Receiving Instructions
  • Mix urine. Measure the total volume and record it on the requisition.
  • Check that the pH falls within between approximately 2 and 4.
  • Transfer 10 mL urine to a screw-capped plastic vial and refrigerate.

Sendouts:

  • Order Mayo Test: CATU
  • Interfaced: Yes [Interface: 601; Worksheet: MARF]

Stability: Refrigerated (preferred): 7 days; Frozen: 14 days; Ambient: 7 days.

All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.

Misc Sendout

Performance

Lab Department
Sendouts Mayo Lab (RF)(MARF)
Frequency
Performed: Monday through Saturday. Report Available: 2-4 days from sample receipt at Mayo Clinic Labs.
Available STAT?
No
Performing Location(s)
Sendout Mayo Clinic Laboratories (Superior Drive)
800-533-1710

3050 Superior Drive NW
Rochester, MN 55901

Billing & Coding

CPT Codes
82384
LOINC
11133-6
Interfaced Order Code
UOW1811