Alberta Precision Laboratories

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Organization:

Alberta Precision Laboratories

Message Alert:

PLEASE NOTE: This Test Directory is in an interim state and due to changes pertaining to the DynaLIFE transition, performing site for routing has not been updated. Please refer to Laboratory Information System for appropriate routing.

Test Name/Synonym:

Metanephrines (Synonym: Metanephrine, Normetanephrine, Plasma Metanephrines)

Test Includes:

Metanephrine and Normetanephrine

Ordering Alert:

Posture at the time of blood collection must be indicated on the requisition or online ordering system. Posture is required to append the correct reference intervals.

Collection Alert:

One full 6 mL or two full 4 mL tubes are required to obtain minimum volume of plasma for this test.

Shipping and Handling Alert:

Specimen MUST be centrifuged and plasma aliquot MUST be transported at refrigerated temperature or frozen. See processing and transportation requirements below.

LABID (Connect Care):

LAB4633

Primary Container:

LAVENDER EDTA

Minimum Collection Volume:

2.5 mL plasma

Specimen Collection Requirements:

Lying flat (supine) collections require the patient to be lying down for 20 minutes before collection.

The patient must fast and abstain from smoking tobacco for at least 4 hours before the specimen is drawn. Water may be consumed during the fasting period.

Test Resources:

Patient Instructions: Fasting Tests

General Laboratory Requisition – 21302 write test name under “Additional Tests”

Processing:

Specimen MUST be centrifuged and plasma aliquoted into a 12 x 75 or 12.5 x 75 mm tube.

Collection sites other than Calgary, Airdrie, Cochrane, and Chestermere: freeze aliquot.

Transportation:

Ensure the specimen has been centrifuged and aliquoted before transporting to the lab.

Calgary, Airdrie, Cochrane, and Chestermere collection sites: transport at refrigerated temperature
Other collection sites and other zones: transport frozen
Diagnostic Scientific Centre: Store frozen after receipt

Testing Schedule:

Weekly

Reference Interval:

Collection Posture: Seated or collection posture information not provided

	Age (years)	nmol/L
Metanephrine	All	Less than 0.50
Normetanephrine	All	Less than 0.90

Collection Posture: Supine (Lying Flat)

Metanephrine
Age (years)	nmol/L
All	Less than 0.50

Normetanephrine
Age (years)	nmol/L	Age (years)	nmol/L
0 - 16	Less than 0.55	62	Less than 1.04
17 – 21	Less than 0.56	63	Less than 1.06
22 - 24	Less than 0.57	64	Less than 1.09
25 - 26	Less than 0.58	65	Less than 1.11
27 - 28	Less than 0.59	66	Less than 1.14
29 - 30	Less than 0.60	67	Less than 1.17
31 - 32	Less than 0.61	68	Less than 1.20
33	Less than 0.62	69	Less than 1.23
34 - 35	Less than 0.63	70	Less than 1.26
36	Less than 0.64	71	Less than 1.29
37	Less than 0.65	72	Less than 1.32
38	Less than 0.66	73	Less than 1.35
39	Less than 0.67	74	Less than 1.38
40	Less than 0.68	75	Less than 1.42
41	Less than 0.69	76	Less than 1.45
42	Less than 0.70	77	Less than 1.49
43	Less than 0.71	78	Less than 1.53
44	Less than 0.72	79	Less than 1.57
45	Less than 0.73	80	Less than 1.60
46	Less than 0.75	81	Less than 1.65
47	Less than 0.76	82	Less than 1.69
48	Less than 0.77	83	Less than 1.73
49	Less than 0.79	84	Less than 1.77
50	Less than 0.80	85	Less than 1.82
51	Less than 0.82	86	Less than 1.86
52	Less than 0.84	87	Less than 1.91
53	Less than 0.85	88	Less than 1.96
54	Less than 0.87	89	Less than 2.00
55	Less than 0.89	90	Less than 2.05
56	Less than 0.91	91	Less than 2.10
57	Less than 0.93	92	Less than 2.16
58	Less than 0.95	93	Less than 2.21
59	Less than 0.97	94	Less than 2.26
60	Less than 0.99	95+	Less than 2.32
61	Less than 1.01

Testing Area:

TDM/Toxicology

Performing Site:

Calgary: Diagnostic and Scientific Centre

Additional Test Information:

The 2014 Endocrine Society Guidelines on Diagnosis of Pheochromocytoma and Paraganglioma recognize that plasma normetanephrine values may be transiently elevated when blood is collected in a seated position compared to blood collected after 20 minutes in the supine (lying flat) position. Plasma metanephrine values are not affected by collection posture.

False positive increases in urine and plasma metanephrines and catecholamines have been associated with the following drugs or classes of drugs: anti-depressants, anti-psychotics, some beta blockers, dihydropyridine calcium channel blockers, some anxiolytics, anti-Parkinson’s drugs, decongestants, phenoxybenzamine.

Interpretation of results while on one of these agents should be interpreted with caution and put into clinical context.

Calgary inpatient collections: SCM requisition will print in Accession. Please indicate on the requisition the collection posture (seated, lying flat). It is the responsibility of the clinical team to ensure the patient has been in the lying flat position for 20 minutes before collection.

Last Updated On:

Tuesday, April 2, 2024