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Test ID HIAAR 5-Hydroxyindoleacetic Acid, Random, Urine


Ordering Guidance


This test uses a random urine collection to assess 5-hydroxyindoleacetic acid concentrations. If a 24-hour urine collection is preferred, order HIAA / 5-Hydroxyindoleacetic Acid, 24 Hour, Urine.



Necessary Information


Patient's age and sex are 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 48 hours prior to specimen collection:

-Acetaminophen (Tylenol or generic versions)

-Tryptophan containing supplements

2. For 48 hours prior to the urine collection, the patient should:

Limit the following to one serving per day:

-Fruits

-Vegetables

-Nuts

-Caffeinated beverages or foods

 

Supplies: Urine Tubes, 10 mL (T068)

Container/Tube: Plastic, 10-mL urine tube

Specimen Volume: 5 mL

Collection Instructions:

1. Collect a random urine specimen.

2. Store and send refrigerate


Useful For

Biochemical diagnosis and monitoring of intestinal carcinoid syndrome using random urine specimens

Method Name

Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)

Reporting Name

5-HIAA, Random, U

Specimen Type

Urine

Specimen Minimum Volume

1 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Urine Refrigerated (preferred) 56 days
  Frozen  365 days

Clinical Information

5-Hydroxyindoleacetic acid (5-HIAA) is the major metabolite of serotonin and is excreted in the urine. Intestinal carcinoid tumors, along with neuroendocrine tumors, can produce excess amounts of 5-HIAA and serotonin, especially in individuals with carcinoid syndrome. Carcinoid syndrome is characterized by carcinoid tumors, flushing, heart disease, and hepatomegaly.

 

Measurement of 5-HIAA in a random urine specimen can diagnose carcinoid disease with a high specificity.

Reference Values

5-HIAA, mg/g creatinine

99th percentile cutoff

Age

Female

Male

 

≤23 months

≤17.53

≤16.42

 

24-35 months

≤17.07

≤15.96

 

3 years

≤16.70

≤15.60

 

4 years

≤16.03

≤14.93

 

5 years

≤15.26

≤14.17

 

6 years

≤14.40

≤13.34

 

7 years

≤13.47

≤12.43

 

8 years

≤12.52

≤11.52

 

9 years

≤11.58

≤10.63

 

10 years

≤10.67

≤9.79

 

11 years

≤9.81

≤9.00

 

12 years

≤9.02

≤8.29

 

13 years

≤8.32

≤7.65

 

14 years

≤7.70

≤7.08

 

15 years

≤7.16

≤6.59

 

16 years

≤6.72

≤6.15

 

17 years

≤6.36

≤5.78

 

18 years

≤6.08

≤5.45

 

19 years

≤5.88

≤5.17

 

20 years

≤5.73

≤4.93

 

21 years

≤5.64

≤4.73

 

22 years

≤5.59

≤4.55

 

23 years

≤5.57

≤4.40

 

24 years

≤5.57

≤4.28

 

25 years

≤5.58

≤4.19

 

26 years

≤5.61

≤4.11

 

27 years

≤5.64

≤4.06

 

28 years

≤5.67

≤4.03

 

29 years

≤5.70

≤4.02

 

30 years

≤5.72

≤4.01

 

31 years

≤5.75

≤4.02

 

32 years

≤5.77

≤4.03

 

33 years

≤5.78

≤4.05

 

34 years

≤5.79

≤4.06

 

35 years

≤5.80

≤4.08

 

36 years

≤5.80

≤4.09

 

37 years

≤5.80

≤4.11

 

38 years

≤5.80

≤4.12

 

39 years

≤5.81

≤4.14

 

40 years

≤5.82

≤4.17

 

41 years

≤5.85

≤4.22

 

42 years

≤5.89

≤4.27

 

43 years

≤5.95

≤4.35

 

44 years

≤6.04

≤4.43

 

45 years

≤6.14

≤4.53

 

46 years

≤6.26

≤4.63

 

47 years

≤6.40

≤4.75

 

48 years

≤6.55

≤4.86

 

49 years

≤6.71

≤4.99

 

50 years

≤6.86

≤5.11

 

51 years

≤7.01

≤5.24

 

52 years

≤7.15

≤5.37

 

53 years

≤7.29

≤5.51

 

54 years

≤7.41

≤5.64

 

55 years

≤7.52

≤5.78

 

56 years

≤7.62

≤5.91

 

57 years

≤7.71

≤6.05

 

58 years

≤7.80

≤6.17

 

59 years

≤7.88

≤6.29

 

60 years

≤7.95

≤6.41

 

61 years

≤8.02

≤6.51

 

62 years

≤8.09

≤6.60

 

63 years

≤8.15

≤6.69

 

64 years

≤8.21

≤6.76

 

65 years

≤8.28

≤6.82

 

66 years

≤8.34

≤6.88

 

67 years

≤8.40

≤6.93

 

68 years

≤8.46

≤6.97

 

69 years

≤8.52

≤7.00

 

70 years

≤8.58

≤7.03

 

71 years

≤8.65

≤7.06

 

72 years

≤8.71

≤7.08

 

73 years

≤8.77

≤7.10

 

74 years

≤8.82

≤7.11

 

75 years

≤8.86

≤7.11

 

76 years

≤8.90

≤7.11

 

77 years

≤8.92

≤7.10

 

78 years

≤8.93

≤7.09

 

79 years

≤8.93

≤7.07

 

80 years

≤8.92

≤7.05

 

81 years

≤8.90

≤7.02

 

82 years

≤8.88

≤7.00

 

83 years

≤8.86

≤6.98

 

84 years

≤8.85

≤6.97

 

85 years

≤8.84

≤6.95

 

86 years

≤8.84

≤6.94

 

87 years

≤8.84

≤6.94

 

88 years

≤8.84

≤6.94

 

>or= 89 years

≤8.85

≤6.93

 

Interpretation

If pharmacological and dietary artifacts have been ruled out, an elevated excretion of 5-hydroxyindoleacetic acid is a probable indicator of the presence of a serotonin-producing tumor.

Clinical Reference

1. Grimaldi F, Fazio N, Attanasio R, et al. Italian Association of Clinical Endocrinologists (AME) position statement: a stepwise clinical approach to the diagnosis of gastroenteropancreatic neuroendocrine neoplasms. J Endocrinol Invest. 2014;37(9):875-909. doi:10.1007/s40618-014-0119-0

2. Vinik A, Hughes MS. Feliberti E, et al: Carcinoid tumors. In: Feingold KR, Anawalt B, Boyce A, et al, eds. Endotext [Internet]. MDText.com, Inc; 2000. Updated February 5, 2018. Accessed May 5, 2021. Available at www.ncbi.nlm.nih.gov/books/NBK279162/

3. Shah D, Mandot A, Cerejo C, et al: The outcome of primary hepatic neuroendocrine tumors: A single-center experience. J Clin Exp Hepatol. 2019 Nov-Dec;9(6):710-715. doi: 10.1016/j.jceh.2019.08.002

4. Perry D, Hayek SS: Carcinoid heart disease: A guide for clinicians. Cardiol Clin. 2019 Nov;37(4):497-503. doi: 10.1016/j.ccl.2019.07.014

5. Degnan AJ, Tocchio S, Kurtom W, Tadros SS: Pediatric neuroendocrine carcinoid tumors: Management, pathology, and imaging findings in a pediatric referral center. Pediatr Blood Cancer. 2017 Sep;64(9). doi: 10.1002/pbc.26477

6. Corcuff JB, Chardon L, El Hajji Ridah I, Brossaud J. Urinary sampling for 5HIAA and metanephrines determination: revisiting the recommendations. Endocr Connect. 2017;6(6):R87-R98. doi:10.1530/EC-17-0071

Day(s) Performed

Monday through Friday

Report Available

2 to 4 days

Test Classification

This test was developed, and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test 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
HIAAR 5-HIAA, Random, U 11145-0

 

Result ID Test Result Name Result LOINC Value
616090 5-HIAA, Random, U 11145-0