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Test Code CATP Catecholamines Fractionated (Epinephrine, Norepinephrine), Plasma

Specimen Required

Patient Preparation: Patient should be calm and supine for 30 minutes prior to collection.  
 
Collect: Green (sodium or lithium heparin). Collect on ice.  
 
Specimen Preparation:
Specimen should be centrifuged and frozen within one hour (refrigerated centrifuge is preferred but not required). Transfer 4 mL plasma to an ARUP Standard Transport Tube. (Min: 2.1 mL)  
 
Storage/Transport Temperature:
CRITICAL FROZEN. Separate specimens must be submitted when multiple tests are ordered.  
 
Unacceptable Conditions: EDTA plasma, serum, or urine.  
  
Stability: After separation from cells:
              Ambient: Unacceptable; Refrigerated: Unacceptable;
              Frozenat -20°C: 1 month; Frozen at -70°C: 1 year  

Methodology

Quantitative High Performance Liquid Chromatography

Reference Interval - Supine

 

Components Reference Interval
  Epinephrine    
Age  
2-​10 days
11 days-​3 months
4-​11 months
12-​23 months
24-​35 months
3-​17 years
18 years and older		 36-​400 pg/mL
55-​200 pg/mL
55-​440 pg/mL
36-​640 pg/mL
18-​440 pg/mL
18-​460 pg/mL
10-​200 pg/mL
  Norepinephrine    
Age  
2-​10 days
11 days-​3 months
4-​11 months
12-​23 months
24-​35 months
3-​17 years
18 years and older		 170-​1180 pg/mL
370-​2080 pg/mL
270-​1120 pg/mL
68-​1810 pg/mL
170-​1470 pg/mL
85-​1250 pg/mL
80-​520 pg/mL

 

Performed

Sunday, Tuesday - Saturday

Results reported in 1-4 days

NYS DOH Approval

This test is NYS DOH approved.

Interpretive Data

Small increases in catecholamines (less than 2 times the upper reference limit) usually are the result of physiological stimuli, drugs, or improper specimen collection. Significant elevation of one or more catecholamines (2 or more times the upper reference limit) is associated with an increased
probability of a neuroendocrine tumor. Measurement of plasma or urine fractionated metanephrines provides better diagnostic sensitivity than measurement of catecholamines.

Higher catecholamine concentrations are observed in specimens collected from upright or standing adults. Epinephrine may be increased by approximately 20 percent and norepinephrine increased up to 700 pg/mL.    

Notes

Medications that may interfere with catecholamines and metabolites include amphetamines and amphetamine-like compounds, appetite suppressants, bromocriptine, buspirone, caffeine, carbidopa-levodopa (Sinemet), clonidine, dexamethasone, diuretics (in doses sufficient to deplete sodium), ethanol, isoproterenol, labetalol, methyldopa (Aldomet), MAO inhibitors, nicotine, nose drops, propafenone (Rythmol), reserpine, theophylline, tricyclic antidepressants, and vasodilators. The effect of drugs on catecholamine results may not be predictable.

For optimum results, patient should be supine for 30 minutes prior to collection.

Children, particularly those under 2 years of age, often show an elevated catecholamine response to stress.