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

Additional Codes

Mayo Test ID
HIAA

Reporting Name

5-Hydroxyindoleacetic Acid, U

Useful For

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

Method Name

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

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. Collection duration and urine volume in milliliters are 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. 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.

2. Collect a 24-hour urine specimen.

Additional Information: See Urine Preservatives-Collection and Transportation for 24-Hour Urine Specimens 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

Reject Due To

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

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

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.

Cautions

Intake of food with a high content of serotonin (avocados, dates, eggplant, all fruit [including bananas, cantaloupe, grapefruit, kiwi fruit, melons, pineapple, plantains, plums], all nuts [including hickory nuts, butternuts, pecans, walnuts], and tomatoes and tomato products) within 48 hours of the urine collection could result in falsely elevated 5-hydroxyindoleacetic acid (5-HIAA) excretion.

 

Numerous drugs affect the excretion of 5-HIAA by different mechanisms, including increased serotonin synthesis, metabolism, and release and inhibition of uptake. The following medications can interfere with 5-HIAA results.

-Acetaminophen (Tylenol or generic versions)

-Tryptophan containing supplements

 

Patient should also avoid caffeinated beverages, such as tea and coffee, or caffeinated foods, such as dark chocolate, for 48 hours before and during specimen collection.

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, Mattern D, Rinaldo P. 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;8[8]:1082-1088)

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. It has not been cleared or approved by the US Food and Drug Administration.