Lab Guide
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Test ID: 5-Hydroxyindoleacetate (24h urine)
5-Hydroxyindoleacetate (24h urine)
5-Hydroxyindoleacetate (24h urine)
Useful For

Urine 5-hydroxyindoleacetate, or 5-hydroxyindoleacetic acid (5-HIAA), is useful in the investigation of carcinoid syndrome.

Method name and description

High performance liquid chromatography coupled to electrochemical detection.

Clinical information

Carcinoid syndrome is a type of neuroendocrine tumour usually presenting with non-specific symptoms such as cutaneous flushing, diarrhoea, and dyspnoea.  Biochemically, carcinoid syndrome is commonly characterised by the excessive secretion of the hormone serotonin, and by the increased production of its metabolite 5-hydroxyindoleacetate (5-hydroxyindoleacetic acid; 5-HIAA).  The measurement of 5-HIAA in urine can, therefore, provide evidence of carcinoid syndrome.

Aliases

5-Hydroxyindoleacetic acid

5-HIAA

Specimen type / Specimen volume / Specimen container

Specimen type: A 24h urine collection, protected from light.

Specimen volume: total urine volume collected in 24 hours.

Specimen container: Suitable plain urine container and must be covered against light.

Collection instructions / Special Precautions / Timing of collection

Serotonin is present in many foods, which should be avoided for at least 48h prior to, and during the 24h urine collection:

Pineapple

Banana

Walnut

Kiwi

Plums

Tomatoes

Avocado

Blackcurrant

Melon

Alcohol

In addition, certain medications can impact the excretion of 5-HIAA and should similarly be avoided:

Imipramine

Isoniazid

Levodopa

Methyldopa

Monoamine oxidase inhibitors

Reserpine

Relevant clinical information to be provided

Presenting clinical signs and symptoms

Storage and transport instructions

Transport Temperature: 2 - 30 °C and must be covered against light.

Storage Temperature: -18°C after add the preservative till the time for processing and must be covered against light.

Specimen Rejection Criteria

Insufficient sample volume received

Sample exposed to light

Biological reference intervals and clinical decision values

24h urine: 10.5 - 47.1 umol/24h

Factors affecting test performance and result interpretation

Many foods (see collection requirements) can increase the excretion of urine 5-HIAA.

Some medications can increase (e.g. cisplatin) or decrease (e.g. levodopa) the excretion of urine 5-HIAA.

Excessively acidified (pH<3) or alkaline (bacterial contamination) can destabilise urine 5-HIAA and lower the measured concentration. 

Turnaround time / Days and times test performed / Specimen retention time

Turnaround time: 5 working days.

Times test performed: Once a week.

Specimen retention time: 30 days.