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Clinical Chemistry, Vol 38, 534-540, Copyright © 1992 by American Association for Clinical Chemistry
IP Kema, EG de Vries, AM Schellings, PE Postmus and FA Muskiet
Central Laboratory for Clinical Chemistry, University of Groningen, The Netherlands.
Carcinoid patients are diagnosed biochemically on the basis of increased urinary excretion of 5-hydroxyindoleacetic acid (5-HIAA); urinary and platelet serotonin concentrations are considered to provide complementary information. Using established HPLC methods with fluorometric detection, we evaluated the clinical usefulness of measurements of urinary 5-HIAA and urinary, plasma, and platelet serotonin in 30 consecutive patients with histologically proven carcinoid tumors of fore-, mid-, and hindgut origin before treatment. Ten patients showed no signs of serotonin overproduction; 14 had increased concentrations of urinary 5-HIAA and platelet serotonin; and platelet serotonin, but not urinary 5-HIAA, was increased in 6. None had increased urinary 5-HIAA excretion without an increase in platelet serotonin content. In cases with high rates of tumor serotonin secretion, platelet serotonin reached a maximum and did not correlate with serotonin secretion rate, whereas urinary 5-HIAA was correlated. Increased platelet serotonin was correlated with increased plasma serotonin and with occurrence of carcinoid syndrome. Increased urinary serotonin, allegedly caused by increases in circulating 5- hydroxytryptophan, almost invariably coincided with increased platelet serotonin, but not necessarily with above-normal urinary 5-HIAA excretion. From these results and long-term monitoring of three patients during treatment, we conclude that platelet serotonin is more sensitive than urinary 5-HIAA for detecting carcinoids that secrete only small amounts of serotonin.
The following articles in journals at HighWire Press have cited this article:
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  D. Zolkowska, M. H. Baumann, and R. B. Rothman Chronic Fenfluramine Administration Increases Plasma Serotonin (5-Hydroxytryptamine) to Nontoxic Levels J. Pharmacol. Exp. Ther., February 1, 2008; 324(2): 791 - 797. [Abstract] [Full Text] [PDF]
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 J R Meinardi, B H R Wolffenbuttel, and R P F Dullaart Cyclic Cushing's syndrome: a clinical challenge Eur. J. Endocrinol., September 1, 2007; 157(3): 245 - 254. [Abstract] [Full Text] [PDF]
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 S. Russo, I. P. Kema, E. B. Haagsma, J. C. Boon, P. H.B. Willemse, J. A. den Boer, E. G.E. de Vries, and J. Korf Irritability Rather Than Depression During Interferon Treatment Is Linked to Increased Tryptophan Catabolism Psychosom Med, September 1, 2005; 67(5): 773 - 777. [Abstract] [Full Text] [PDF]
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 E. J. Mulder, A. Oosterloo-Duinkerken, G. M. Anderson, E. G.E. De Vries, R. B. Minderaa, and I. P. Kema Automated On-Line Solid-Phase Extraction Coupled with HPLC for Measurement of 5-Hydroxyindole-3-acetic Acid in Urine Clin. Chem., September 1, 2005; 51(9): 1698 - 1703. [Abstract] [Full Text] [PDF]
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S. Russo, J. C. Boon, I. P. Kema, P. H.B. Willemse, J. A. den Boer, J. Korf, and E. G.E. de Vries Patients With Carcinoid Syndrome Exhibit Symptoms of Aggressive Impulse Dysregulation Psychosom Med, May 1, 2004; 66(3): 422 - 425. [Abstract] [Full Text] [PDF]
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 W. G. Meijer, E. van der Veer, P. L. Jager, E. J. van der Jagt, B. A. Piers, I. P. Kema, E. G.E. de Vries, and P. H.B. Willemse Bone Metastases in Carcinoid Tumors: Clinical Features, Imaging Characteristics, and Markers of Bone Metabolism J. Nucl. Med., February 1, 2003; 44(2): 184 - 191. [Abstract] [Full Text] [PDF]
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I. P. Kema, W. G. Meijer, G. Meiborg, B. Ooms, P. H.B. Willemse, and E. G.E. de Vries Profiling of Tryptophan-related Plasma Indoles in Patients with Carcinoid Tumors by Automated, On-Line, Solid-Phase Extraction and HPLC with Fluorescence Detection Clin. Chem., October 1, 2001; 47(10): 1811 - 1820. [Abstract] [Full Text] [PDF]
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P. L. Jager, W. G. Meijer, I. P. Kema, P. H.B. Willemse, D. A. Piers, and E. G.E. de Vries L-3-[123I]Iodo-{alpha}-Methyltyrosine Scintigraphy in Carcinoid Tumors: Correlation with Biochemical Activity and Comparison with [111In-DTPA-D-Phe1]-Octreotide Imaging J. Nucl. Med., November 1, 2000; 41(11): 1793 - 1800. [Abstract] [Full Text] [PDF]
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W. G. Meijer, I. P. Kema, M. Volmer, P. H.B. Willemse, and E. G.E. de Vries Discriminating Capacity of Indole Markers in the Diagnosis of Carcinoid Tumors Clin. Chem., October 1, 2000; 46(10): 1588 - 1596. [Abstract] [Full Text] [PDF]
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M.-S. Lee, F.-C. Cheng, H.-Z. Yeh, T.-Y. Liou, and J.-H. Liu Determination of Plasma Serotonin and 5-Hydroxyindoleacetic Acid in Healthy Subjects and Cancer Patients Clin. Chem., March 1, 2000; 46(3): 422 - 423. [Full Text] [PDF]
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