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HelpOrder Code META3 Metanephrines with 3-Methoxytyramine, 24 Hour, Urine
Ordering Guidance
Necessary Information
24-Hour volume (in milliliters) is required.
Specimen Required
Patient Preparation: Tricyclic antidepressants, labetalol, and sotalol medications may elevate levels of metanephrines producing results that cannot be interpreted. If clinically feasible, it is optimal to discontinue these medications at least 1 week before collection. For advice on assessing the risk of removing patients from these medications and alternatives, consider consultation with a specialist in endocrinology or hypertension.
Supplies: Urine Tubes, 10 mL (T068)
Submission Container/Tube: Plastic urine tube
Specimen Volume: 10 mL
Collection Instructions:
1. Complete 24-hour urine collections are preferred, especially for patients with episodic hypertension; ideally the collection should begin at the onset of a "spell."
2. Add 10 g (pediatric: 3 g) of boric acid or 25 mL (pediatric: 15 mL) of 50% acetic acid as preservative at start of collection.
3. Collect urine for 24 hours.
Useful For
A first- and second-tier screening test for the presumptive diagnosis of catecholamine-secreting pheochromocytomas and paragangliomas
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| 3MT1 | 3-Methoxytyramine, U | Yes, (Order 3MT) | Yes |
| METAF | Metanephrines, Fractionated, 24h, U | Yes | Yes |
Special Instructions
Method Name
Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)
Reporting Name
Metanephrines with 3-MT, 24h, USpecimen Type
UrineSpecimen Minimum Volume
4 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Urine | Refrigerated (preferred) | 28 days |
| Frozen | 28 days | |
| Ambient | 21 days |
Reject Due To
| Gross hemolysis | OK |
| Gross icterus | OK |
Reference Values
3-Methoxytyramine:
Males: ≤306 mcg/24 h
Females: ≤242 mcg/24 h
METANEPHRINE
Males
Normotensives
3-8 years: 29-92 mcg/24 h
9-12 years: 59-188 mcg/24 h
13-17 years: 69-221 mcg/24 h
≥18 years: 44-261 mcg/24 h
Reference values have not been established for patients that are younger than 36 months.
Hypertensives: <400 mcg/24 h
Females
Normotensives
3-8 years: 18-144 mcg/24 h
9-12 years: 43-122 mcg/24 h
13-17 years: 33-185 mcg/24 h
≥18 years: 30-180 mcg/24 h
Reference values have not been established for patients that are younger than 36 months.
Hypertensives: <400 mcg/24 h
NORMETANEPHRINE
Males
Normotensives
3-8 years: 34-169 mcg/24 h
9-12 years: 84-422 mcg/24 h
13-17 years: 91-456 mcg/24 h
18-29 years: 103-390 mcg/24 h
30-39 years: 111-419 mcg/24 h
40-49 years: 119-451 mcg/24 h
50-59 years: 128-484 mcg/24 h
60-69 years: 138-521 mcg/24 h
≥70 years: 148-560 mcg/24 h
Reference values have not been established for patients that are younger than 36 months.
Hypertensives: <900 mcg/24 h
Females
Normotensives
3-8 years: 29-145 mcg/24 h
9-12 years: 55-277 mcg/24 h
13-17 years: 57-286 mcg/24 h
18-29 years: 103-390 mcg/24 h
30-39 years: 111-419 mcg/24 h
40-49 years: 119-451 mcg/24 h
50-59 years: 128-484 mcg/24 h
60-69 years: 138-521 mcg/24 h
≥70 years: 148-560 mcg/24 h
Reference values have not been established for patients that are younger than 36 months.
Hypertensives: <900 mcg/24 h
TOTAL METANEPHRINE
Males
Normotensives
3-8 years: 47-223 mcg/24 h
9-12 years: 201-528 mcg/24 h
13-17 years: 120-603 mcg/24 h
18-29 years: 190-583 mcg/24 h
30-39 years: 200-614 mcg/24 h
40-49 years: 211-646 mcg/24 h
50-59 years: 222-680 mcg/24 h
60-69 years: 233-716 mcg/24 h
≥70 years: 246-753 mcg/24 h
Reference values have not been established for patients that are younger than 36 months.
Hypertensives: <1300 mcg/24 h
Females
Normotensives
3-8 years: 57-210 mcg/24 h
9-12 years: 107-394 mcg/24 h
13-17 years: 113-414 mcg/24 h
18-29 years: 142-510 mcg/24 h
30-39 years: 149-535 mcg/24 h
40-49 years: 156-561 mcg/24 h
50-59 years: 164-555 mcg/24 h
60-69 years: 171-616 mcg/24 h
≥70 years: 180-646 mcg/24 h
Reference values have not been established for patients that are younger than 36 months.
Hypertensives: <1300 mcg/24 h
For International System of Units (SI) conversion for Reference Values, see www.mayocliniclabs.com/order-tests/si-unit-conversion.html
Method Description
Urine samples are acidified and hydrolyzed in a heat block, then metanephrine and normetanephrine are extracted from the specimens utilizing extraction cartridges. Analyte concentrations are determined through analysis performed by a liquid chromatography tandem mass spectrometry method.(Unpublished Mayo method)
Urinary 3-methoxytyramine is determined by reverse-phase liquid chromatography tandem mass spectrometry with stable isotope dilution analysis.(Unpublished Mayo method)
Day(s) Performed
Monday through Friday
Performing Laboratory
Mayo Clinic Laboratories in Rochester
CPT Code Information
82542
83835
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| META3 | Metanephrines with 3-MT, 24h, U | 101400-0 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 8552 | Metanephrine, U | 104629-1 |
| 609422 | 3-Methoxytyramine, U | 32618-1 |
| 21545 | Normetanephrine, U | 104631-7 |
| 83006 | Total Metanephrines, U | 104630-9 |
| TM50 | Collection Duration (h) | 13362-9 |
| VL48 | Volume (mL) | 3167-4 |
| 2434 | Comment | 48767-8 |