Vanillylmandelic Acid

Extra-regional sites: see Vanillylmandelic Acid, Extra-regional

80 mL aliquot of acidified 24 hour urine collection.

Newborn to Adult:
Refer to charts in Specimen Handling and Additional Information sections.

Refrigerate during collection.
Urine specimen collection container must have preservative
pouch(es) added prior to collection.

Acidify specimen in original collection container.

Record 24 hour volume and collection (start and end) dates and time
in space provided on requisition.

Mix well and pour off acidified aliquot.
Sample pH should be less than 3.0.

ACH: Random samples from children collected or received at
ACH Laboratory will be forwarded to Biochemical Genetics Laboratory. 
DO NOT acidify. Use mnemonic MISCBGL. Random samples from another
site MUST be frozen immediately after collection and transported on ice.

PSC: Specimens received with requisitions indicating that analysis is to
be performed by the Biochemical Genetics Laboratory are to be sent to
ACH Laboratory who will forward to Biochemical Genetics Laboratory. 
Samples MUST be frozen immediately after collection and transported
on ice.

ADULT Collection Type	Weight of Sulfamic acid in pouch for ADULT Collections
24 hr. collections on patients > 4 yrs.	7 g pouch in each 4 liter container collection
Adult timed collections	7 g pouch in each 4 liter container collection
Adult random collections	0.5 g pouch for every 100 mL collected (orange capped urine container = 100 mL)

Collection Type for  NEWBORN up to 4 YRS	Weight of Sulfamic acid pouch for NEWBORN up to 4 YRS
24 hr. collections on newborn up to 4 yrs.	Use acidification chart in Additional Information section
Random collection on newborn up to 4 yrs.	Refer patient to ACH

Metanephrines will be performed only. VMA testing has restricted clinical indications and requires review and approval by CLS Medical & Scientific Staff. Contact LIC at 770-3600 for Pathologist On Call information.

The following drugs cause physiological interference with the levels of either urine metanephrines, catecholamines, VMA or HVA:
Physiological decreases: clonidine, decaborane, guanethine, guanfacine, methylDOPA, Oubain, reserpine, tosylate bretylium, imipramine, moclobemide.
Physiological increases: Atenolol, dopamine, isoproterenol, nifedipine, nitroglycerin, prochlorperazine, rauwolfia, levodopa, disulfiram, MAO inhibitors.

For Acidification of Pediatric 24 hour Urines:

Age	Number of 0.5 g pouches of Sulfamic acid to add when acidifying during collection
Up to 1 month	Not suitable for 0.5 g pouch Refer patient to ACH
1 up to 2 months	2
2 up to 4 months	3
4 up to 12 months	4
12 months up to 4 yrs.	5

24 HOUR
Age	µmol/d
3-5 years	5-13
6-9 years	10-16
10-16 years	12-26
17-150 years	<36