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Test Code SERO-SERUM Serotonin, Serum

Additional Codes

AllScripts (AEHR) Orderable:  Serotonin Serum

Performing Laboratory

LabCorp Burlington, NC

Methodology

Liquid chromatography/tandem mass spectrometry (LC/MS-MS)

Specimen Requirements

Container/Tube: Gold-top tube

Specimen : 1 mL serum(0.5 mL min)

Transport Temperature: Refrigerated

Stability:  7 Days Room Temperature or Refrigerated               

                 14 Days Frozen

 

Note:  Monoamine oxidase inhibitor drugs should be discontinued for at least one week prior to sampling since they tend to increase the level of serotonin.

Separate serum from cells within 30 minutes of collection and transfer to a plastic transport tube.

Reference Values

Male: 21−321 ng/mL

Female: 0−420 ng/mL

 

TAT: 4-6 Days

 

This test was developed and its performance characteristics determined by LabCorp. It has not been cleared or approved by the Food and Drug Administration.

 

Test Classification and CPT Coding

84260

 

LOINC Code: : 27057-9

 

Computer Interface Code

PDM #  5907505

Used For

Serotonin measurement is used in conjunction with urinary 5-hydroxyindoleacetic acid (5-HIAA) and/or serum chromogranin A in the diagnosis of carcinoid syndrome.

Limitations

The majority of gastroenteropancreatic neuroendocrine, carcinoid tumors do not produce elevated whole blood or serum serotonin levels. In most cases, 5-hydroxyindoleacetic acid (5-HIAA) and chromogranin A are superior tests for the assessment of carcinoid syndrome.1-4 In rare instances, a deficiency of aromatic amino acids decarboxylase in carcinoid tumor cell limits the conversion of 5-HTP into serotonin.17

Several medications (lithium, monoamine oxidase inhibitors, methyldopa, morphine, and reserpine) can produce elevation in serotonin concentration. Selective serotonin reuptake inhibitors can cause a reduction in serum and whole blood serotonin levels. Tryptophan-rich food (avocados, bananas, plums, walnuts, pineapple, eggplant, plantain, tomatoes, hickory nuts, kiwi, dates, grapefruit, cantaloupe, and honeydew melon) do not contribute to serum or blood serotonin measurements.12,13

Footnotes

1. Aggarwal G, Obideen K, Wehbi M. Carcinoid tumors: What should increase our suspicion? Cleve Clin J Med. 2008 Dec;75(12):849-855. PubMed 19088003

2. Robertson RG, Geiger WJ, Davis NB. Carcinoid tumors. Am Fam Physician. 2006 Aug 1;74(3):429-434. PubMed 16913162

3. Modlin IM, Lye KD, Kidd M. A 50-year analysis of 562 gastric carcinoids: small tumor or larger problem? Am H Gastroenterol. 2004 Jan;99(1):23-32. PubMed 14687136

4. Zueterhorst JM, Taal BG. Metastatic carcinoid tumors: a clinical review. Oncologist. 2005 Feb;10(2):123-131. PubMed 15709214

5. Ramage JK, Ahmed A, Ardill J, et al. Guidelines for the management of gastroenteropancreatic neuroendocrine (including carcinoid) tumours (NETs). Gut. 2012 Jan;61(1):6-32. PubMed 22052063

6. Ghevariya V, Malieckal A, Ghevariya N, Mazumder M, Arand S. Carcinoid tumors of the gastrointestinal tract. South Med J. 2009 Oct;102(10):1032-1040. PubMed 19738517

7. van der Horst-Schrivers AN, Wymenga AN, Links TP, Willemse PH, Kema IP, deVries EG. Complications of midgut carcinoid tumors and carcinoid syndrome. Neuroendocrinology. 2004;80 Suppl 1:28-32. PubMed 15477713

8. Pape UF, Perren A, Niederle B, et al. ENETS Consensus Guidelines for the management if patients with neuroendocrine neoplasms from the jejuno-ileum and the appendix including goblet cell carcinomase. Neuroendocrinology. 2012;95(2):135-156. PubMed 22262080

9. Robiolio PA, Rigolin VH, Wilson JS, et al. Carcinoid heart disease. Correlation of high serotonin levels with valvular abnormalities detected by cardiac catheterization and echocardiography. Circulation. 1995 Aug 15;92(4):790-795. PubMed 7641358

10. Klimstra DS, Modlin IR, Coppola D, Lloyd RV, Suster S. The pathologic classification of neuroendocrine tumors. a review of nomenclature, grading, and stagging systems. Pancreas. 2010 Aug;39(6):707-712. PubMed 20664470

11. Castiello RJ, Lynch PJ. Pellagra and the carcinoid syndrome. Arch Dermatol. 1972 Apr;105(4):574-577. PubMed 4259595

12. Kema IP, Schellings AM, Meiborg G, Hoppenbrouwers CJ, Muskiet FA. Influence of a serotonin-and dopamine-rich diet on platelet serotonin content and urinary excretion of biogenic amines and their metabolites. Clin Chem. 1992 Sep;38:1730-1736. PubMed 1382000

13. Kema IP, de Vires EG, Muskiet FA. Clinical chemistry of serotonin and metabolites. J Chromatogr B Biomed Appl. 2000 Sep 29;747(1-2):33-48. PubMed 11103898

14. Pussard E, Guigueno N, Adam O, Giudicelli JF. Validation of HPLC-amperometric detection to measure serotonin in plasma, platelets, whole blood, and urine. Clin Chem. 1996 Jul;42(7): 1086-1091. PubMed 8674193

15. Carling RS, Degg TJ, Allen KR, Bax NDS, Barth JH. Evaluation of whole blood serotonin and plasma and urine 5-hydroxyindole- acetic acid in the diagnosis of carcinoid disease. Ann Clin Biochem. 2002 Nov;39(Pt 6):577-582. PubMed 12564839

16. Allen KR, Degg TJ, Anthoney DA, Fitzroy-Smith D. Monitoring the treatment of carcinoid disease using blood serotonin and plasma 5-hydroxyindoleacetic acid: three case examples. Ann Clin Biochem. 2007 May;44(Pt 3):300-307. PubMed 17456301

17. Feldman JM. Serotonin metabolism in patients with carcinoid tumors; incidence of 5-hydroxytryptohan-secreting tumors. Gastroenterology. 1978 Dec;75(6):1109-1114. PubMed 309417

 

1. Aggarwal G, Obideen K, Wehbi M. Carcinoid tumors: What should increase our suspicion? Cleve Clin J Med. 2008 Dec;75(12):849-855.19088003

2. Robertson RG, Geiger WJ, Davis NB. Carcinoid tumors. Am Fam Physician. 2006 Aug 1;74(3):429-434.16913162

3. Modlin IM, Lye KD, Kidd M. A 50-year analysis of 562 gastric carcinoids: small tumor or larger problem? Am H Gastroenterol. 2004 Jan;99(1):23-32.14687136

4. Zueterhorst JM, Taal BG. Metastatic carcinoid tumors: a clinical review. Oncologist. 2005 Feb;10(2):123-131.15709214

5. Ramage JK, Ahmed A, Ardill J, et al. Guidelines for the management of gastroenteropancreatic neuroendocrine (including carcinoid) tumours (NETs). Gut. 2012 Jan;61(1):6-32.22052063

6. Ghevariya V, Malieckal A, Ghevariya N, Mazumder M, Arand S. Carcinoid tumors of the gastrointestinal tract. South Med J. 2009 Oct;102(10):1032-1040.19738517

7. van der Horst-Schrivers AN, Wymenga AN, Links TP, Willemse PH, Kema IP, deVries EG. Complications of midgut carcinoid tumors and carcinoid syndrome. Neuroendocrinology. 2004;80 Suppl 1:28-32.15477713

8. Pape UF, Perren A, Niederle B, et al. ENETS Consensus Guidelines for the management if patients with neuroendocrine neoplasms from the jejuno-ileum and the appendix including goblet cell carcinomase. Neuroendocrinology. 2012;95(2):135-156.22262080

9. Robiolio PA, Rigolin VH, Wilson JS, et al. Carcinoid heart disease. Correlation of high serotonin levels with valvular abnormalities detected by cardiac catheterization and echocardiography. Circulation. 1995 Aug 15;92(4):790-795.7641358

10. Klimstra DS, Modlin IR, Coppola D, Lloyd RV, Suster S. The pathologic classification of neuroendocrine tumors. a review of nomenclature, grading, and stagging systems. Pancreas. 2010 Aug;39(6):707-712.20664470

11. Castiello RJ, Lynch PJ. Pellagra and the carcinoid syndrome. Arch Dermatol. 1972 Apr;105(4):574-577.4259595

12. Kema IP, Schellings AM, Meiborg G, Hoppenbrouwers CJ, Muskiet FA. Influence of a serotonin-and dopamine-rich diet on platelet serotonin content and urinary excretion of biogenic amines and their metabolites. Clin Chem. 1992 Sep;38:1730-1736.1382000

13. Kema IP, de Vires EG, Muskiet FA. Clinical chemistry of serotonin and metabolites. J Chromatogr B Biomed Appl. 2000 Sep 29;747(1-2):33-48.11103898

14. Pussard E, Guigueno N, Adam O, Giudicelli JF. Validation of HPLC-amperometric detection to measure serotonin in plasma, platelets, whole blood, and urine. Clin Chem. 1996 Jul;42(7): 1086-1091.8674193

15. Carling RS, Degg TJ, Allen KR, Bax NDS, Barth JH. Evaluation of whole blood serotonin and plasma and urine 5-hydroxyindole- acetic acid in the diagnosis of carcinoid disease. Ann Clin Biochem. 2002 Nov;39(Pt 6):577-582.12564839

16. Allen KR, Degg TJ, Anthoney DA, Fitzroy-Smith D. Monitoring the treatment of carcinoid disease using blood serotonin and plasma 5-hydroxyindoleacetic acid: three case examples. Ann Clin Biochem. 2007 May;44(Pt 3):300-307.17456301

17. Feldman JM. Serotonin metabolism in patients with carcinoid tumors; incidence of 5-hydroxytryptohan-secreting tumors. Gastroenterology. 1978 Dec;75(6):1109-1114.309417

 

1. Aggarwal G, Obideen K, Wehbi M. Carcinoid tumors: What should increase our suspicion? Cleve Clin J Med. 2008 Dec;75(12):849-855.19088003

2. Robertson RG, Geiger WJ, Davis NB. Carcinoid tumors. Am Fam Physician. 2006 Aug 1;74(3):429-434.16913162

3. Modlin IM, Lye KD, Kidd M. A 50-year analysis of 562 gastric carcinoids: small tumor or larger problem? Am H Gastroenterol. 2004 Jan;99(1):23-32.14687136

4. Zueterhorst JM, Taal BG. Metastatic carcinoid tumors: a clinical review. Oncologist. 2005 Feb;10(2):123-131.15709214

5. Ramage JK, Ahmed A, Ardill J, et al. Guidelines for the management of gastroenteropancreatic neuroendocrine (including carcinoid) tumours (NETs). Gut. 2012 Jan;61(1):6-32.22052063

6. Ghevariya V, Malieckal A, Ghevariya N, Mazumder M, Arand S. Carcinoid tumors of the gastrointestinal tract. South Med J. 2009 Oct;102(10):1032-1040.19738517

7. van der Horst-Schrivers AN, Wymenga AN, Links TP, Willemse PH, Kema IP, deVries EG. Complications of midgut carcinoid tumors and carcinoid syndrome. Neuroendocrinology. 2004;80 Suppl 1:28-32.15477713

8. Pape UF, Perren A, Niederle B, et al. ENETS Consensus Guidelines for the management if patients with neuroendocrine neoplasms from the jejuno-ileum and the appendix including goblet cell carcinomase. Neuroendocrinology. 2012;95(2):135-156.22262080

9. Robiolio PA, Rigolin VH, Wilson JS, et al. Carcinoid heart disease. Correlation of high serotonin levels with valvular abnormalities detected by cardiac catheterization and echocardiography. Circulation. 1995 Aug 15;92(4):790-795.7641358

10. Klimstra DS, Modlin IR, Coppola D, Lloyd RV, Suster S. The pathologic classification of neuroendocrine tumors. a review of nomenclature, grading, and stagging systems. Pancreas. 2010 Aug;39(6):707-712.20664470

11. Castiello RJ, Lynch PJ. Pellagra and the carcinoid syndrome. Arch Dermatol. 1972 Apr;105(4):574-577.4259595

12. Kema IP, Schellings AM, Meiborg G, Hoppenbrouwers CJ, Muskiet FA. Influence of a serotonin-and dopamine-rich diet on platelet serotonin content and urinary excretion of biogenic amines and their metabolites. Clin Chem. 1992 Sep;38:1730-1736.1382000

13. Kema IP, de Vires EG, Muskiet FA. Clinical chemistry of serotonin and metabolites. J Chromatogr B Biomed Appl. 2000 Sep 29;747(1-2):33-48.11103898

14. Pussard E, Guigueno N, Adam O, Giudicelli JF. Validation of HPLC-amperometric detection to measure serotonin in plasma, platelets, whole blood, and urine. Clin Chem. 1996 Jul;42(7): 1086-1091.8674193

15. Carling RS, Degg TJ, Allen KR, Bax NDS, Barth JH. Evaluation of whole blood serotonin and plasma and urine 5-hydroxyindole- acetic acid in the diagnosis of carcinoid disease. Ann Clin Biochem. 2002 Nov;39(Pt 6):577-582.12564839

16. Allen KR, Degg TJ, Anthoney DA, Fitzroy-Smith D. Monitoring the treatment of carcinoid disease using blood serotonin and plasma 5-hydroxyindoleacetic acid: three case examples. Ann Clin Biochem. 2007 May;44(Pt 3):300-307.17456301

17. Feldman JM. Serotonin metabolism in patients with carcinoid tumors; incidence of 5-hydroxytryptohan-secreting tumors. Gastroenterology. 1978 Dec;75(6):1109-1114.309417

References

Kocha W, Maroun J, Kennecke H, et al. Consensus recommendations for the diagnosis and management of well- differentiated gastroentererohepatic neuroendocrine tumours: a revised statement from a Canadian National Expert Group. Curr Oncol. 2010 Jun;17(3):49-64. PubMed 20567626

Meijer W, Kema I, Volmer M, Willemse PH, de Vries EG. Discriminating capacity of indole markers in the diagnosis of carcinoid tumors. Clin Chem. 2000 Oct;46(10):1588-1596. PubMed 11017936