Serial measurement of urinary VMA and HVA levels from one infant: a study for neuroblastoma mass screening.

Urinary vanillylmandelic acid (VMA), homovanillic acid (HVA), and creatinine in 188 samples from one infant during the ages of 1 to 12 months were measured serially by high-performance liquid chromatography (HPLC). The mean VMA and HVA levels of the total 188 samples in this study were 11.9 +/- 1.39 and 22.9 +/- 2.92 micrograms/mg creatinine with coefficients of variation (CVs) 11.7% and 12.8%, respectively; and of 76 samples from 5 to 12 months of age, 12.3 +/- 0.84 and 23.1 +/- 2.03 micrograms/mg creatinine with CVs 6.8% and 8.8%. The CVs of VMA and HVA levels expressed in microgram per milligram of creatinine had decreased after 6 months of age (VMA, 5.0% to 8.3%, HVA, 5.3% to 8.4%). Chromatograms demonstrated the similar pattern from 1 to 12 months of age, although the infant had been fed foods typical in Japan, which included breast milk, seasonal fruits, vegetables, fish, chicken, and meat. Diurnal fluctuations of VMA and HVA levels in urine were not significant. When HPLC is used for measurement of VMA, HVA, and creatinine, it is not necessary to restrict foods that cause false-positive results in the qualitative VMA test from the infant's diet. Furthermore, random urine samples obtained throughout the 12 months could be effectively used for the measurement of these substances.