'Sweet Dreams', 'Happy Days' and elevated 24-h urine 5-hydroxyindoleacetic acid excretion

Ann Clin Biochem. 2013 Jan;50(Pt 1):80-2. doi: 10.1258/acb.2012.012041. Epub 2012 Oct 19.

Abstract

We report two patients with markedly elevated 24-h urine 5-hydroxyindoleacetic acid (5-HIAA) excretion due to over-the-counter (OTC) self-medication with 5-hydroxytryptophan (5-HTP). It is important to recognize that OTC medication may cause increased 'false-positive' 5-HIAA excretion to prevent undue patient anxiety and unnecessary further investigation for carcinoid disease. Discordance between chromogranin A and 24-h urine 5-HIAA results should alert to the possibility of false-positive or -negative laboratory results.

Publication types

  • Case Reports

MeSH terms

  • 5-Hydroxytryptophan / administration & dosage
  • 5-Hydroxytryptophan / metabolism*
  • Aged
  • Chromatography, High Pressure Liquid
  • Chromogranin A / blood
  • False Positive Reactions
  • Female
  • Humans
  • Hydroxyindoleacetic Acid / urine*
  • Malignant Carcinoid Syndrome / diagnosis
  • Malignant Carcinoid Syndrome / urine
  • Middle Aged
  • Nonprescription Drugs / administration & dosage
  • Nonprescription Drugs / metabolism*
  • Serotonin / metabolism

Substances

  • Chromogranin A
  • Nonprescription Drugs
  • Serotonin
  • Hydroxyindoleacetic Acid
  • 5-Hydroxytryptophan