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Test Code LAB20069 5-Hydroxyindoleacetic Acid, 24 Hour, Urine

Reporting Name

5-Hydroxyindoleacetic Acid, U

Useful For

Biochemical diagnosis and monitoring of intestinal carcinoid syndrome using 24-hour urine specimens

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Urine


Ordering Guidance


This test is the preferred test for measurement of 5-hydroxyindoleacetic acid concentrations. If a random urine collection is preferred, order HIAAR / 5-Hydroxyindoleacetic Acid, Random, Urine.



Necessary Information


1. 24-hour volume is required.

2. 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, as well as during, specimen collection:

-Acetaminophen (Tylenol or generic versions)

-Tryptophan containing supplements

2. For 48 hours prior to, as well as during, 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 24-hour urine specimen.

2. Add 25 mL of 50% acetic acid as preservative at start of collection. Use 15 mL of 50% acetic acid for children <5 years old.

Additional Information: See Urine Preservatives-Collection and Transportation for 24-Hour Urine Specimens in Special Instructions for multiple collections.


Specimen Minimum Volume

1 mL

Specimen Stability Information

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

Reference Values

 

5-HIAA, mg/24 hour

99th percentile cutoff

Age

Female

Male

≤23 months

≤2.7

≤2.3

24-35 months

≤3.0

≤2.6

3 years

≤3.2

≤2.9

4 years

≤3.4

≤3.2

5 years

≤3.6

≤3.6

6 years

≤3.8

≤3.9

7 years

≤4.0

≤4.2

8 years

≤4.2

≤4.5

9 years

≤4.5

≤4.8

10 years

≤4.7

≤5.1

11 years

≤4.9

≤5.3

12 years

≤5.2

≤5.6

13 years

≤5.4

≤5.8

14 years

≤5.6

≤6.1

15 years

≤5.7

≤6.3

16 years

≤5.9

≤6.4

17 years

≤6.0

≤6.6

18 years

≤6.0

≤6.7

19 years

≤6.1

≤6.8

20 years

≤6.1

≤6.9

21 years

≤6.2

≤6.9

22 years

≤6.2

≤7.0

23 years

≤6.2

≤7.0

24 years

≤6.3

≤7.1

25 years

≤6.3

≤7.2

26 years

≤6.3

≤7.2

27 years

≤6.4

≤7.3

28 years

≤6.4

≤7.4

29 years

≤6.5

≤7.5

30 years

≤6.6

≤7.5

31 years

≤6.6

≤7.6

32 years

≤6.7

≤7.7

33 years

≤6.8

≤7.7

34 years

≤6.8

≤7.8

35 years

≤6.9

≤7.9

36 years

≤6.9

≤7.9

37 years

≤7.0

≤8.0

38 years

≤7.0

≤8.1

39 years

≤7.0

≤8.2

40 years

≤7.1

≤8.2

41 years

≤7.1

≤8.3

42 years

≤7.2

≤8.4

43 years

≤7.3

≤8.5

44 years

≤7.4

≤8.6

45 years

≤7.4

≤8.7

46 years

≤7.5

≤8.8

47 years

≤7.6

≤8.9

48 years

≤7.6

≤9.0

49 years

≤7.7

≤9.1

50 years

≤7.7

≤9.2

51 years

≤7.8

≤9.3

52 years

≤7.8

≤9.4

53 years

≤7.9

≤9.5

54 years

≤8.0

≤9.6

55 years

≤8.1

≤9.7

56 years

≤8.1

≤9.7

57 years

≤8.2

≤9.8

58 years

≤8.3

≤9.8

59 years

≤8.3

≤9.8

60 years

≤8.3

≤9.9

61 years

≤8.3

≤9.9

62 years

≤8.4

≤9.9

63 years

≤8.4

≤10.0

64 years

≤8.4

≤10.0

65 years

≤8.4

≤10.0

66 years

≤8.5

≤10.1

67 years

≤8.5

≤10.1

68 years

≤8.5

≤10.1

69 years

≤8.5

≤10.2

70 years

≤8.5

≤10.2

71 years

≤8.6

≤10.2

72 years

≤8.6

≤10.2

73 years

≤8.5

≤10.1

74 years

≤8.5

≤10.1

75 years

≤8.6

≤10.1

76 years

≤8.6

≤10.0

77 years

≤8.6

≤10.0

78 years

≤8.6

≤10.0

79 years

≤8.6

≤10.0

80 years

≤8.7

≤9.9

81 years

≤8.7

≤9.9

82 years

≤8.7

≤9.9

83 years

≤8.7

≤9.9

84 years

≤8.7

≤9.9

85 years

≤8.6

≤9.8

86 years

≤8.5

≤9.8

87 years

≤8.4

≤9.7

88 years

≤8.3

≤9.7

89 years

≤8.1

≤9.5

90 years

≤7.9

≤9.4

91 years

≤7.6

≤9.2

92 years

≤7.4

≤9.0

93 years

≤7.1

≤8.8

94 years

≤7.0

≤8.7

= 95 years

≤6.9

≤8.6

 

For SI unit Reference Values, see www.mayocliniclabs.com/order-tests/si-unit-conversion.html

Day(s) Performed

Monday through Friday

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
HIAA 5-Hydroxyindoleacetic Acid, U 1695-6

 

Result ID Test Result Name Result LOINC Value
9248 5-Hydroxyindoleacetic Acid, U 1695-6
TM35 Collection Duration 13362-9
VL33 Urine Volume 3167-4

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 24-hour urine specimen can diagnose carcinoid disease with a high specificity.

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.

Method Description

5-Hydroxyindoleacetic acid (5-HIAA) is measured by solid phase extraction of an aliquot from a 24-hour urine collection and liquid chromatography tandem mass spectrometry analysis. 5-HIAA is quantitated using a custom synthesized stable isotope labeled internal standard (d6-5-HIAA) from calibration over a concentration range 0.5 to 150 mg/L.(Kroll CA, Magera MJ, Helgeson JK, et al: A liquid chromatography-tandem mass spectrometry method for the determination of 5-hydroxyindole-3-acetic acid in urine. Clin Chem. 2002;48:2049-2051; Calanchini M, Tadman M, Krogh J, Fabbri A, Grossman A, Shine B: Measurement of urinary 5-HIAA: correlation between spot versus 24-h urine collection. Endocr Connect. 2019 Aug 1;8[8]:1082-1088)

Report Available

2 to 4 days

Method Name

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

Urine Preservative Collection Options

Note: The addition of preservative or application of temperature controls must occur within 4 hours of completion of the collection.

Ambient

No

Refrigerate

OK

Frozen

OK

50% Acetic Acid

Preferred

Boric Acid

OK

Diazolidinyl Urea

No

6M Hydrochloric Acid

OK

6M Nitric Acid

OK

Sodium Carbonate

OK

Thymol

OK

Toluene

OK

Covenant HealthCare Laboratory Test Directory Note:

PH NEEDS TO BE BETWEEN 0 AND 5.

Reject Due To

  All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.