HMI-102 also increased tyrosine, brain
5-hydroxyindoleacetic acid and changed coat color, indicating production of melanin.
Serotonin decomposes to
5-hydroxyindoleacetic acid (5-HIAA) by monoamine oxidase which is excreted via urine (9).
The most useful diagnostic test for carcinoid tumor is the 24-hour urinary test for
5-hydroxyindoleacetic acid (5-HIAA), the metabolic end-product of serotonin.
Levels of catecholamine and its metabolites in the serum and 24 hour urine Parameter (unit) Value Normal range Metanephrine (nmol/L) 0.13 0.08-0.51 Serum Normetanephrine (nmol/L) 19.78 0.12-1.18 Epinephrine (pg/mL) 109.5 0-60 Norepinephrine (pg/mL) >14000 120-680 Creatinine (g/day) 0.68 0.30-0.80 Metanephrine (g/day) 157.3 59-188 Metanephrine / Creatinine ratio 232.3 41-209 (g/g creatinine) Urine Normetanephrine (g/day) 10862.2 84-422 Normetanephrine / Creatinine ratio ([micro]g/g 16038.6 53-413 creatinine) Vanillylmandelic acid (mg/day) 218.8 1.8-6.7
5-hydroxyindoleacetic acid (mg/day) 3.82 0.5-8.2 Table II.
Normally, 1% of dietary tryptophan is converted to serotonin, but in carcinoid, 70% of it is converted to serotonin, which in turn is converted to
5-hydroxyindoleacetic acid (5-HIAA) in the liver and secreted in urine.
Low CSF
5-hydroxyindoleacetic acid (AsbergM [9] et al), metabolite of serotonin has been associated with impulsive aggression and suicidal behaviour.
In addition, CGA intervention solely increased 2-ethylhydracrylic acid, pyrocatechol, and 3-hydroxybenzoic acid, accompanied by decreased 4-deoxyerythronic acid, nicotinamide, asparagine, D-arabitol, fructose, D-mannose,
5-hydroxyindoleacetic acid, and 2-hydroxyglutarate.
Follow-up consists of imaging (CT or Magnetic Resonance Imaging) and urinary
5-hydroxyindoleacetic acid (5-HIAA) every three to four months in the first year.
Serum CgA can be used as a screening or monitoring test for NET in combination with the specific metabolic test for that particular NET (e.g., plasma fractionated metanephrines for pheochromocytoma, plasma
5-hydroxyindoleacetic acid for carcinoid, plasma gastrin for gastrinomas, plasma glucagon for glucagonomas) and necessary radiological investigation(s), all of which will help to diagnose the burden and progress of the tumor.
The importance of urine
5-hydroxyindoleacetic acid levels in the early diagnosis of acute appendicitis.
Serum and 24 hr urine
5-hydroxyindoleacetic acid (5-HIAA) were within normal reference range.
24-hour urine
5-hydroxyindoleacetic acid and vasointestinal peptide were normal.