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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. 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.


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 Special Container
Plasma Frozen (preferred) 60 days
  Refrigerated  72 hours

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.

Clinical Reference

1. Oleinikov K, Avniel-Polak S, Gross DJ, Grozinsky-Glasberg S. Carcinoid syndrome: Updates and review of current therapy. Curr Treat Options Oncol. 2019 Jul 9;20(9):70. doi: 10.1007/s11864-019-0671-0

2. Adaway JE, Dobson R, Walsh J, et al. Serum and plasma 5-hydroxyindoleacetic acid as an alternative to 24-h urine 5-hydroxyindoleacetic acid measurement. Ann Clin Biochem. 2016 Sep;53(Pt 5):554-560. doi: 10.1177/0004563215613109

3. Tohmola N, Johansson A, Sane T, et al: Transient elevation of serum 5-HIAA by dietary serotonin and distribution of 5-HIAA in serum protein fractions. Ann Clin Biochem. 2015 Jul;52(Pt 4):428-33. doi: 10.1177/0004563214554842

4. Tellez MR, Mamikunian G, O'Dorisio TM, Vinik AI, Woltering EA. A single fasting plasma 5-HIAA value correlates with 24-hour urinary 5-HIAA values and other biomarkers in midgut neuroendocrine tumors (NETs). Pancreas. 2013 Apr;42(3):405-10. doi: 10.1097/MPA.0b013e318271c0d5

Day(s) Performed

Monday, Wednesday, Friday

Report Available

3 to 6 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

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