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HVA and HMMA/VMA

Clinical Biochemistry

Sample and container requirements

Plain Spot Urine

Minimum volume required

1 mL urine

Special requirements

Adjust pH to 3.0 - 3.5 on receipt in the laboratory.

Patient preparation

None

Sample viability

Turnaround time

2 days

Reference range

HVA: Infant: 4 – 25 µmol/mmol creatinine 1 – 5 years: 2 – 15 µmol/mmol creatinine >5 years: 2 – 13 µmol/mmol creatinine HMMA/VMA: Infant: 2 – 12 µmol/mmol creatinine 1 year – 5 years: 2 – 9 µmol/mmol creatinine > 5 years: 1 – 7 µmol/mmol creatinine

Clinical guidance

Neuroblastoma is a neoplastic disease of infants and early childhood and is the third most common malignant cancer tumours in paediatric patients. Approximately 80% are found in children under 5 years of age. Elevated values of homovanillic acid (HVA, a metabolite of dopamine) and HMMA/VMA (a metabolite of metadrenalines), may be suggestive of the presence of neuroblastoma. HVA and HMMA/VMA can be used for the diagnosis and follow up treatment of neuroblastoma.

Notes

Please contact the Duty Biochemist on 0121 424 1392 (or bleep 2506) prior to sending samples for this test.

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This information was last updated on 19 August 2026