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. The ordering provider should decide if any medications should be stopped and when they should be restarted. If clinically feasible, discontinue the following medications at least 24 hours prior to specimen collection:
-Acetaminophen (Tylenol or generic versions)
-Tryptophan containing supplements.
2. For 24 hours prior to the collection, the patient should:
Limit the following to one serving per day:
-Fruits
-Vegetables
-Caffeinated beverages or foods
Abstain from the following:
-Nuts, especially walnuts. Plasma 5-hydroxyindoleacetic acid levels revert to baseline levels when walnuts are ingested after other foods.
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 | Special Container |
---|---|---|---|
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 |