Test Code HIAAP 5-Hydroxyindoleacetic Acid, Plasma
Ordering Guidance
This test quantifies 5-hydroxyindoleacetic acid in plasma specimens and is comparable to testing on 24-hour and random urine specimens for the diagnosis and monitoring of intestinal carcinoid syndrome.
Necessary Information
Patient's age is required.
Specimen Required
Patient Preparation:
1. Some medications could interfere with test results. If medically feasible, for 48 hours before and during specimen collection, patient should not take the following medications:
-Acetaminophen (Tylenol or generic versions)
-Tryptophan containing supplements.
2. For 24 hours prior to and during collection, the patient should limit the following to one serving per day:
-Fruits
-Vegetables
-Caffeinated beverages or foods
3. For 24 hours prior to and during collection, patients should not eat nuts, especially walnuts. Plasma 5-hydroxyindoleacetic acid levels revert to baseline levels when walnuts are ingested after other foods.
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container/Tube:
Preferred: Green top (sodium heparin)
Acceptable: Lavender top (EDTA)
Submission Container/Tube: Plastic vial
Specimen Volume: 0.5 mL
Collection Instructions:
1. Centrifuge at 4° C.
2. Aliquot plasma into plastic vial.
3. Send plasma frozen.
Secondary ID
619735Useful For
Biochemical diagnosis and monitoring of intestinal carcinoid syndrome using a plasma specimen
Method Name
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Reporting Name
5-Hydroxyindoleacetic Acid, PSpecimen Type
PlasmaSpecimen Minimum Volume
0.2 mL
Specimen Stability Information
Specimen Type | Temperature | Time |
---|---|---|
Plasma | Frozen (preferred) | 60 days |
Refrigerated | 72 hours |
Reject Due To
Gross hemolysis | OK |
Thawing** | Cold OK; Warm reject |
Gross lipemia | OK |
Gross icterus | OK |
Clinical Information
Intestinal carcinoid and neuroendocrine tumors can produce excess amounts of serotonin and its degradation product, 5-hydroxyindoleacetic acid (5-HIAA). Determination of 5-HIAA in urine or plasma is used to diagnose and monitor patients with carcinoid syndrome.
Carcinoid syndrome is characterized by a constellation of hormonal symptoms such as abdominal pain, increased bowel movements, episodic facial flushing, bronchoconstriction, venous telangiectasia, niacin deficiency-related symptoms, and long-term complications, such as mesenteric fibrosis and carcinoid heart disease.(1)
Measurement of 5-HIAA in a plasma specimen can diagnose carcinoid disease and produces comparable results to urinary 5-HIAA testing.
Reference Values
≤6 months: ≤130 ng/mL
>6 months: ≤30 ng/mL
Interpretation
If pharmacological and dietary artifacts have been ruled out, an elevated concentration of 5-hydroxyindoleacetic acid is a probable indicator of the presence of a serotonin-producing tumor.
CPT Code Information
83497
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
HIAAP | 5-Hydroxyindoleacetic Acid, P | 1693-1 |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
619735 | 5-Hydroxyindoleacetic Acid, P | 1693-1 |