Test Catalog

Test Id : 3MT

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3-Methoxytyramine, 24 Hour, Urine

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Overview

Test Catalog

Useful For
Suggests clinical disorders or settings where the test may be helpful

A first- and second-order screening test for the presumptive diagnosis of catecholamine-secreting pheochromocytomas and paragangliomas

 

Testing in conjunction or as an alternative to plasma metanephrines (PMET / Metanephrines, Fractionated, Free, Plasma) or plasma catecholamine (CATP / Catecholamine Fractionation, Free, Plasma) testing

Special Instructions
Library of PDFs including pertinent information and forms related to the test

Method Name
A short description of the method used to perform the test

Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

3-Methoxytyramine, 24h, U

Aliases
Lists additional common names for a test, as an aid in searching

3MT

3-methoxy-4-hydroxyphenethylamine

Methoxytyramine

Methoxytramine

3-Methoxytramine

3-Methoxytyramine

Urine Dopamine

Specimen Type
Describes the specimen type validated for testing

Urine

Necessary Information

24-Hour volume is required.

ORDER QUESTIONS AND ANSWERS

Question ID Description Answers
TM120 Collection Duration
VL120 Urine Volume

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Patient Preparation: Tricyclic antidepressants, labetalol, and sotalol medications may elevate levels of catecholamines producing results that cannot be interpreted. If clinically feasible, it is optimal to discontinue these medications at least 1 week before collection. Levodopa (Sinemet) medication will cause false-positive results. 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. Collect urine for 24 hours.

3. 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.

Additional Information: See Urine Preservatives-Collection and Transportation for 24-Hour Urine Specimens for multiple collections.

Special Instructions
Library of PDFs including pertinent information and forms related to the test

Forms

 

Urine Preservative Collection Options

Note: The addition of preservative must occur prior to beginning the collection.

Ambient

OK

Refrigerate

OK

Frozen

OK

50% Acetic Acid

Preferred

Boric Acid

Preferred

Diazolidinyl Urea

No

6M Hydrochloric Acid

OK

6M Nitric Acid

OK

Sodium Carbonate

OK

Thymol

No

Toluene

OK

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.

3 mL

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

Gross hemolysis OK
Gross icterus OK

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Urine Refrigerated (preferred) 28 days
Frozen 90 days
Ambient 28 days

Useful For
Suggests clinical disorders or settings where the test may be helpful

A first- and second-order screening test for the presumptive diagnosis of catecholamine-secreting pheochromocytomas and paragangliomas

 

Testing in conjunction or as an alternative to plasma metanephrines (PMET / Metanephrines, Fractionated, Free, Plasma) or plasma catecholamine (CATP / Catecholamine Fractionation, Free, Plasma) testing

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Pheochromocytoma is a rare, though potentially lethal, tumor of chromaffin cells of the adrenal medulla that produces episodes of hypertension with palpitations, severe headaches, and sweating (spells). Patients with pheochromocytoma may also be asymptomatic and present with sustained hypertension or an incidentally discovered adrenal mass.

 

Pheochromocytomas and other tumors derived from neural crest cells (eg, paragangliomas and neuroblastomas) secrete catecholamines (epinephrine, norepinephrine, and dopamine). Dopamine secreting tumors are rarer than norepinephrine and epinephrine secreting tumors.

 

3-Methoxytyramine (3MT), metanephrine, and normetanephrine are the metabolites of dopamine, epinephrine, and norepinephrine, respectively. These metabolites are further metabolized to vanillylmandelic acid. Pheochromocytoma cells also have the ability to oxymethylate catecholamines into metanephrines that are secreted into circulation.

 

This test may be used as the first test for low-suspicion cases and as a confirmatory study in patients with less than a 2-fold elevation in plasma free fractionated catecholamines. This is highly desirable, as the very low population incidence rate of pheochromocytoma (<1:100,000 population per year) will otherwise result in large numbers of unnecessary, costly, and sometimes risky imaging procedures.

Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

Males: < or =306 mcg/24 hours

Females: < or =242 mcg/24 hours

Interpretation
Provides information to assist in interpretation of the test results

Further clinical investigation (eg, radiographic studies) and genetic studies are warranted in patients whose 3-methoxytyramine (3MT) levels are elevated and there is a very high clinical index of suspicion.

 

Increased 3MT levels are found in patients with pheochromocytoma and dopamine-secreting tumors.

 

3MT levels of 306 mcg/24 hours or less in males and 242 mcg/24 hours or less in females can be detected in non-pheochromocytoma hypertensive patients.

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

This test utilizes a liquid chromatography/tandem mass spectrometry (LC-MS/MS) method and is not affected by the interfering substances that affected older spectrophotometric (Pisano reaction) methods (ie, diatrizoate, chlorpromazine, hydrazine derivatives, imipramine, monoamine oxidase [MAO] inhibitors, methyldopa, phenacetin, ephedrine, or epinephrine) or acetaminophen in high-performance liquid chromatography (HPLC) methods.

 

This method is not subject to the known interference of acetaminophen (seen with the plasma metanephrine HPLC-electrochemical detection method).

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. van Duinen N, Corssmit EPM, de Jong WHA, Brookman D, Kema IP, Romijn JA: Plasma levels of free metanephrines and 3-methoxytyramine indicate a higher number of biochemically active HNPGL than 24-h urinary excretion rates of catecholamines and metabolites. Eur J Endocrinol. 2013 Aug 28;169(3):377-382. doi: 10.1530/EJE-13-0529

2. van Duinen N, Steenvoorden D, Kema IP, et al: Increased urinary excretion of 3-methoxytyramine in patients with head and neck paragangliomas. J Clin Endocrinol Metab. 2010 Jan:95(1):209-214. doi: 10.1210/jc.2009-1632

3. Kantorovich V, Pacak K: Interest of urinary dosage of 3- methoxytyramine in the diagnosis of pheochromocytoma and paraganglioma: report of 28 cases. Ann Clin Biol. 2011;69(5):555-559. doi: 10.1684 /abc.2011.0612

4. Muskiet FA, Thomasson CG, Gerding AM, Fremouw-Ottevangers DC, Nagel GT, Wolthers BG: Determination of catecholamines and their 3-O-methylated metabolites in urine by mass fragmentography with use of deuterated internal standards. Clin Chem. 1979 Mar;25(3):453-460

5. Shen Y, Cheng L: Biochemical diagnosis of pheochromocytoma and paraganglioma. In: Mariani-Costantini R, ed. Paraganglioma: A Multidisciplinary Approach. Codon Publications; 2019. doi: 10.15586/paraganglioma.2019.ch2. Accessed: April 2020. Available at: www.ncbi.nlm.nih.gov/books/NBK543224/

Special Instructions
Library of PDFs including pertinent information and forms related to the test

Method Description
Describes how the test is performed and provides a method-specific reference

Urinary 3-methoxytyramine (3MT) is determined by reverse-phase liquid chromatography-tandem mass spectrometry (LC-MS/MS) stable isotope dilution analysis.(Unpublished Mayo method)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday through Friday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

3 to 5 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

2 weeks

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their account representative. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

This test was developed, and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

82542

LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

Test Id Test Order Name Order LOINC Value
3MT 3-Methoxytyramine, 24h, U 32618-1
Result Id Test Result Name Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
65157 3-Methoxytyramine, U 32618-1
TM120 Collection Duration 13362-9
VL120 Urine Volume 3167-4

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports