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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

619735

Useful 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, P

Specimen Type

Plasma

Specimen 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