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Test Details
Test Code:PL0306
Test Name:V M A- Vanyl Mandelic Acid, Urine
Test Details & Preparation
The vanillylmandelic acid (VMA) test is primarily used to detect and rule out neuroblastomas in children with an abdominal mass or other symptoms suggestive of the disease. It may be ordered along with a homovanillic acid (HVA) test to help diagnose a neuroblastoma, to monitor the effectiveness of treatment, and to monitor for neuroblastoma recurrence. A urine creatinine is typically also ordered, especially with random urine testing, and tests results are frequently reported as VMA-to-creatinine and HVA-to-creatinine ratios. Since creatinine is a substance that is excreted in the urine at a relatively constant rate, it serves as a comparison to the rate of VMA and HVA excretion.

VMA testing is ordered when a doctor either suspects that a child has a neuroblastoma or wants to rule out the possibility. The doctor may order it, along with a homovanillic acid (HVA) test, when a child has abdominal mass or other symptoms suggestive of a neuroblastoma. These signs can vary depending upon their location and may vary over time.

The VMA test may also be ordered when a child has been treated for a neuroblastoma and ordered periodically to monitor for recurrence. A VMA test may be ordered along with one or more metanephrine or catecholamine tests when a doctor suspects that a person has a pheochromocytoma. They may be ordered when a person has persistent or recurring hypertension that is not responding to conventional therapies, to monitor the effectiveness of treatment for a pheochromocytoma, and periodically to monitor for recurrence.

Since the VMA test is sensitive to many outside influences, and neuroblastomas and pheochromocytoma are rare, a doctor may see more false positives with this test than true positives. When a person has large amounts of VMA in his urine, it is not diagnostic of a condition it is an indication that further investigation is necessary.

Intense emotional and physical stresses can cause moderate to large temporary increases in VMA levels. The doctor must evaluate the child or adult as a whole - his physical condition, emotional state, prescribed medications, and any over-the-counter products that he is taking.

If a child or adult is being treated for a neuroblastoma or pheochromocytoma, then decreasing VMA concentrations indicate a response to treatment stable or increasing levels indicate that the treatment is not effective. If a VMA concentration is initially normal and then increases in a person who has had a previous neuroblastoma or pheochromocytoma, then it is likely that the tumour is recurring.

Most of the children with a neuroblastoma will produce excess VMA and homovanillic acid. If a VMA and other catecholamine and metanephrine testing are normal, then it is less likely that a child has a neuroblastoma or an adult has a pheochromocytoma, but it cannot be ruled out.
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