5-HIAA,QUANTITATIVE 24 HOUR URINE

Code
900.0050
Name
5-HIAA,QUANTITATIVE 24 HOUR URINE
Category
None
Department
Send-Out
Start Date
Expiration Date
Synonyms
Serotonin Metabolite (Quantitative); HIAA (Quantitative); Hydroxyindoleacetic Acid (Quantitative)
CPT Codes
83497
Site
SBMF
Reference Test
23236
ATLAS Test Code

Specimen Information

Type

Urine, 24-Hour

Volume

10.0 ml

Transport Info

Refrigerated

Fasting Required?
False
Patient Instructions

NO PRESERVATIVES

For 72 hours prior to and during collection, observe the following restrictions:
Dietary: avoid avocados, bananas, eggplant, pineapple, plums, tomatoes, or walnuts.

Other: avoid medications, over-the-counter drugs, or herbal remedies.

Reference Range

0.7–8.2 mg/day
Levels greater than 25 mg/day suggest the presence of a serotonin excreting tumor

Methodology

High Performance Liquid Chromatography (HPLC)

Clinical Significance

Carcinoids are the most common tumors arising from the diffuse neuroendocrine system of the GI tract and pancreas. As with normal gut endocrine cells, carcinoids synthesize, store, and release a variety of hormones and biogenic amines. Serotonin is one of the best characterized among these substances.

Overproduction of serotonin is found in 90 to 100% of patients with carcinoid syndrome. Measurement of serotonin and its metabolites in body fluid and tissue is important in the evaluation of this syndrome. Serotonin is converted to the metabolite, 5-hydroxyindoleacetic acid (5-HIAA), and is excreted by the kidneys. As a result, urinary determination of 5-HIAA is the most frequently used test for the diagnosis of carcinoid syndrome.

In pathological conditions, 5-HIAA is excreted in very large amounts, often exceeding 350 mg/day. However, it is critical to use a more sensitive 5-HIAA method for early diagnosis when tumors are small and not metastasized. 5-HIAA excretion values of these tumors barely exceed 8 mg/day. SBMF is replacing the previous qualitative method with a new, more sensitive, quantitative method for 5-HIAA.

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