5-Hydroxyindoleacetic Acid, 24 Hour, Urine - Seattle Children's Hospital

Reporting Name

5-Hydroxyindoleacetic Acid, U

Useful For

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

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.

Seattle Children's Hospital Note:

Preservative addition preferred, not required as long as sample was refrigerated during and after collection.

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

Day(s) Performed

Monday through Friday

Seattle Children's Hospital Note:

TAT: 4 - 6 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Method Name

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

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)

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

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.

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

Special Instructions

Urine Preservatives-Collection and Transportation for 24-Hour Urine Specimens

Report Available

2 to 4 days

Urine Preservative Collection Options

Note: The addition of preservative must occur prior to beginning the collection.

Ambient (no additive)	No
Refrigerate (no additive)	OK
Frozen (no additive)	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

Forms

If not ordering electronically, complete, print, and send an Oncology Test Request (T729) with the specimen.

Reject Due To

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

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Test Code 5HIAA U 5-Hydroxyindoleacetic Acid, 24 Hour, Urine