General

Synonym/Acronym:
Epinephrine, norepinephrine, dopamine.

Rationale
To assist in diagnosing catecholamine-secreting tumors, such as those found in the adrenal medulla, and in the investigation of hypertension. The test is used to assist in diagnosing pheochromocytoma (a benign tumor of the adrenal gland) and paraganglioma; also as a work-up of neuroblastoma (a rare tumor that most often originates in the nervous tissue of the adrenal medulla).

Patient Preparation
Instruct the patient to follow a normal-sodium diet for 3 days before testing, to avoid consumption of foods high in amines for 48 hr before testing, and to withhold food and fluids for 10 to 12 hr before the test. Instruct the patient to avoid self-prescribed medications for 2 wk before testing (especially appetite suppressants and cold and allergy medications, such as nose drops, cough suppressants, and bronchodilators). Instruct the patient to withhold prescribed medication (especially methyldopa, epinephrine, levodopa, and methenamine mandelate) by medical direction. Protocols may vary among facilities. The patient should also abstain from smoking tobacco for 24 hr before testing. Usually, a 24-hr urine collection is ordered. Instruct the patient to avoid excessive exercise and stress during the 24-hr collection of urine. As appropriate, provide the required urine collection container and specimen collection instructions.

Normal Findings
Method: High-performance liquid chromatography.

Critical Findings and Potential Interventions
N/A