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Test Code SER Serotonin, Serum

Reporting Name

Serotonin, S

Useful For

In conjunction with, or as an alternative to first-order test in the differential diagnosis of isolated symptoms suggestive of carcinoid syndrome, in particular flushing (5-HIAA or serum chromogranin A measurements are first-line tests)

 

Second-order test in the follow-up of patients with known or treated carcinoid tumors in serum specimens

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Serum


Additional Testing Requirements


First-line testing for the diagnosis of carcinoid tumors with symptoms suggestive of carcinoid syndrome consists of urinary serotonin (SERU / Serotonin, 24 Hour, Urine), urinary 5-HIAA (HIAA / 5-Hydroxyindoleacetic Acid [5-HIAA], 24 Hour, Urine), and serum chromogranin A (CGAK / Chromogranin A, Serum).



Specimen Required


Patient Preparation: Patient should be off of medications that may affect serotonin concentrations including lithium, monoamine oxidase inhibitors, methyldopa, morphine, and reserpine.

Collection Container/Tube:

Preferred: Red top

Acceptable: Serum gel

Submission Container/Tube: Plastic vial

Specimen Volume: 2.5 mL

Collection Instructions: Centrifuge as soon as blood has clotted and aliquot into plastic vial.


Specimen Minimum Volume

1.1 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 21 days
  Frozen  90 days
  Ambient  4 days

Reference Values

≤230 ng/mL

Day(s) and Time(s) Performed

Monday, Wednesday, Friday; 10 a.m.

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information

84260

LOINC Code Information

Test ID Test Order Name Order LOINC Value
SER Serotonin, S 27057-9

 

Result ID Test Result Name Result LOINC Value
84395 Serotonin, S 27057-9

Clinical Reference

1. Kema IP, Schellings AM, Meibotg G, et al: Influence of a serotonin and dopamine-rich diet on platelet serotonin content and urinary excretion of biogenic amines and their metabolites. Clin Chem 1992;38:1730-1736

2. Kema IP, de Vries EG, Muskiet FA: Clinical chemistry of serotonin and metabolites. J Chromatogr B Biomed Sci Appl 2000;747:33-48

3. Meijer W, Kema I, Volmer M, et al: Discriminating capacity of indole markers in the diagnosis of carcinoid tumors. Clin Chem 2000;46:1588-1596

4. Ganim RB, Norton JA: Recent advances in carcinoid pathogenesis, diagnosis and management. Surg Oncol 2000;9:173-179

Method Description

Serotonin is removed from serum using reversed-phase solid-phase extraction (SPE). Separation is completed using a Bond Elut C18 SPE cartridge, and is eluted with 40% acetonitrile/1 mM ammonium acetate/0.1% formic acid. The eluate is analyzed using liquid chromatography/tandem mass spectrometry (LC-MS/MS) and quantified using a stable isotope-labeled internal standard, d(4)-serotonin.(Carling RS, Degg TS, Allen KR, et al: valuation of whole blood serotonin and plasma and urine 5-hydroxyindole acetic acid in diagnosis of carcinoid disease. Ann Clin Biochem 2002;39:577-582)

Analytic Time

4 days

Reject Due To

Gross hemolysis OK
Gross lipemia OK
Gross icterus OK

Method Name

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