The diagnostic utility of urinary 5-HIAA for carcinoid syndrome is limited
with a diagnostic sensitivity of about 40-50%. Moreover there is the
influence of diet which might cause false positive results. We replaced the
urinary 5-HIAA assay for the diagnosis of carcinoid syndrome by the assay of
platelet serotonin. This assay has a diagnostic sensitivity which is about
25% higher than for urinary 5-HIAA. Besides the influence of the diet is
much lesser e.g. dietary serotonin does not influence platelet serotonin,
while urinary 5-HIAA might be influenced considerably. This work has been
published a number of years ago by I.Kema from the academic hospital in
Groningen (the Netherlands). The assay of 5-HIAA in urine, however, is still
in use in monitoring the treatment of carcinoid syndrome.
Therefore, I suggest to abandon the urinary 5-HIAA assay from the diagnostic
procedure in the screening of carcinoid syndrome and replace it by platelet
serotonin.
Dr. A. J. Bakker, Klinisch chemicus,
St. Klinisch Chemisch Laboratorium,
Postbus 850,
8901 BR LEEUWARDEN.
Tel.: 058-2888444
Fax: 058-2882227
E-mail: [log in to unmask]
> Does anyone have enough experience to comment on a frequently asked
> question in our GI service, about the diagnostic utility of urinary 5-HIAA
> for Carcinoid Syndrome? Specifically, they want to know how high above
> the upper reference limit does the test have good predictive value, given
> the many dietary and drug related factors known to affect this test.
>
> Thank you in anticipation,
>
> Mario D'Costa Ph.D. FCACB
> Director of Clinical Chemistry and Core Lab
> St. Joseph's Health Centre, Toronto
> Assistant Professor, University of Toronto
> Tel: (416) 530-6263
> Fax: (416) 530-6559
> Email: [log in to unmask]
>
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