What is HVA and VMA ratio?

What is HVA and VMA ratio?

The HVA/VMA ratio reflects the balance between dopamine and norepinephrine/ epinephrine production by catecholamine producing neurons in the central nervous system, sympathetic nervous system, and adrenal gland.

Is Vanillylmandelic acid a Metanephrine?

Measurement of metanephrine, an intermediate metabolite between epinephrine and vanillylmandelic acid, is now considered the most sensitive and specific test for pheochromocytoma.

What is the significance of measuring Metanephrine and Vanillylmandelic acid in urine?

This test measures the amount of VMA that is passed into the urine, typically over a 24-hour period, to detect excess epinephrine and norepinephrine. It is used to detect tumors called neuroblastomas and other neuroendocrine tumors.

What is a normal VMA level?

Normal Values: VMA: 2 to 7 mg/24-hours.

What are catecholamines and Metanephrines?

Metanephrines are made when your body breaks down hormones called catecholamines. These hormones are made by the adrenal glands. Catecholamines help your body respond to stress. They are sometimes called “fight or flight” hormones.

Where is Vanillylmandelic acid from?

5.4. Vanillylmandelic acid (VMA) is produced in the liver and is a major product of norepinephrine and epinephrine metabolism excreted in the urine. Therefore VMA is a poor diagnostic marker for pheochromocytoma given that very little is derived from catecholamine and metanephrines.

What causes elevated VMA?

Moderately elevated VMA (vanillylmandelic acid) can be caused by a variety of factors such as essential hypertension, intense anxiety, intense physical exercise, and numerous drug interactions (including some over-the-counter medications and herbal products).

How do you take a urine sample for a VMA test?


  1. The test is done in the urine.
  2. Collect 24 hours urine sample. Discard the first urine sample and not the time. Now collect all urine samples in the container containing 6 mL of HCl.
  3. Refrigerate the urine during collection and is stable for 2 weeks.
  4. The sample is stable for 2 weeks at 2 to 4 °C.

What causes elevated Homovanillic?

Moderately elevated HVA (homovanillic acid) may be caused by a variety of factors such as essential hypertension, intense anxiety, intense physical exercise, and numerous drug interactions (including some over-the-counter medications and herbal products).

What is the difference between metanephrine and normetanephrine?

1. The chemical structure of normetanephrine (upper panel) and metanephrine (lower panel). In humans, the physiological enantiomers are L-NMN and L-MN. Metanephrine has a higher molecular weight (197) because, in contrast to NMN (183), it contains a methylated amino group.

What is metanephrine and normetanephrine?

Metanephrine and normetanephrine are catecholamines that result when adrenaline breaks down. Healthcare providers disagree on the best test for diagnosing adrenal gland tumors. Some providers believe a urine test to measure catecholamines is better than this blood test because it has fewer false-positive results.

What is normal VMA level?

How do you prepare for a Vanillylmandelic acid test?

The patient should avoid self-prescribed medications (especially aspirin) and prescribed medications (especially pyridoxine, levodopa, amoxicillin, carbidopa, reserpine, and disulfiram) for 2 wk before testing and as directed. The patient should avoid excessive exercise and stress during the 24-hr collection of urine.

What does high homovanillic acid mean?

Clinical Information Elevated values of homovanillic acid (HVA), vanillylmandelic acid (VMA), and other catecholamine metabolites (eg, dopamine) may be suggestive of the presence of a catecholamine-secreting tumor (eg, neuroblastoma, pheochromocytoma, or other neural crest tumors).

Where to get vanillylmandelic acid (VMA) and homovanillic acid measured?

1 Seattle Children’s Hospital, Department of Laboratories, 4800 Sand Point Way NE, Seattle, WA 98105, United States. Background: Vanillylmandelic acid (VMA) and homovanillic acid (HVA) are typically measured in urine for the diagnosis and monitoring of neuroblastoma, a tumor in children <5 y.

What is the significance of homovanillic acid and vanillylmandelic acid in neuroblastoma?

Homovanillic acid (HVA) and vanillylmandelic acid (VMA) concentrations are elevated in more than 90% of patients with neuroblastoma; both tests should be performed. A positive test could be due to a genetic or nongenetic condition.

Can urinary homovanillic acid and vanillylmandelic acid quantify dopamine metabolism in autistic children?

Background: Studies suggest dopamine nervous systems are involved in the pathogenesis of autistic disorder. Quantification of urinary homovanillic acid (HVA) and vanillylmandelic acid (VMA) can be a very important tool in the study of disorders of dopamine metabolism in autistic children.

What is the normal range of vanillylmandelic acid in urine?

Homovanillic Acid – per 24h: 18 years and older: 0.0-15.0 mg/d: Vanillylmandelic Acid – per 24h: 18 years and older: 0.0-7.0 mg/d: The HVA-to-creatinine ratio and VMA-to-creatinine ratio will be reported when the patient is under 18 years, the urine collection is random or other than 24 hours, or the urine volume is less than 400 mL/24 hours.