Pathology Handbook

Catecholamines

Synonyms

Adrenaline, noradrenaline.

Clinical Indications

Investigation of suspected phaeochromocytoma

Test Includes

Free epinephrine (adrenaline), Free norepinephrine (nor-adrenaline)

Request Form

Request on ICE

Availability

On request.

Specific Criteria

Investigation of suspected phaeochromocytoma

Patient Preparation

Certain foods (bananas, pineapples, kiwi fruit, nuts and avocados) must be avoided prior to and during collection of urine.

Turnaround Time

1 week

Specimen

24 hour urine collection into acid preservative

Container

Acidified 24 hour urine container

Lab Handling

Sent to referral laboratory (Basildon Hospital)

Causes for Rejection

Non-acidified urine collection; unlabelled in incorrectly labelled sample

Reference Range

Interpretation

Raised epinephrine and norepinephrine. If slightly elevated (less than 2 x upper limit of ref. range) suggest review medication and repeat collection ensuring foods listed above are avoided. Please note that B-blockers may raise norepinephrine levels (usually less than 1,000 nmol/24hr).If either level greater than this then medullary phaeochromocytoma possible.

Raised norepinephrine with normal/low epinephrine. If less than 1,000 then may be stress related, but a small extra-medullary tumour cannot be excluded. Suggest review medication and repeat collection ensuring foods listed above are avoided. Please note that B-blockers may raise norepinephrine levels (usually less than 1,000 nmol/24hr). If level greater than 1,000 then extra-medullary tumour possible. 

Raised epinephrine with normal norepinephrine. If less than 220 then may be stress related, but a small medullary phaeochromocytoma cannot be excluded. Suggest review medication and repeat collection ensuring foods listed above are avoided. If level greater than 220 then medullary phaeochromocytoma possible.