Elevated urinary dopamine in adults and children

Background Information on the significance of an elevated urinary dopamine is limited and can lead to misinterpretation of the cause of such a finding. This laboratory-based study examines the associations with elevated dopamine gathered from a significant number of patients. Methods The urine catecholamine and metabolite results of specimens (analysed by HPLC-ECD) from 5933 adults and 467 children were examined retrospectively over a 57-month period. Those with elevated dopamine were identified and the explanation for this finding was sought. Results In adults, the conditions associated with an elevated dopamine were: urine over-collection; drug effects (including those due to intravenous dopamine, L-dopa, methyldopa, clozapine, antidepressants and metoclopramide); clinical effects (including those due to phaeochromocytoma, carcinoid tumour and pregnancy). In children, high urine dopamine was found in cases of neuroblastoma, Costello syndrome, leukaemia, phaeochromocytoma, Menkes disease and rhabdomyosarcoma of the bladder. Conclusions A high urine dopamine was found in < 3% of adult urine specimens. It was most commonly associated with: over-collection, probable drug effects and neural crest tumours. Neuroblastoma was the most common cause of elevated dopamine in children's specimens, although other associations are described. Some await explanation.