Carcinoid syndrome laboratory tests

Laboratory findings consistent with the diagnosis of carcinoid syndrome include an elevated urinary 5-hydroxyindoleacetic acid (5-HIAA) and plasma levels of Chromogranin A (CgA) levels.N-terminal pro–B-type natriuretic peptide is a useful biomarker of carcinoid heart disease.

• Urinary 5-hydroxyindoleacetic acid (5-HIAA) are elevated and plasma levels of Chromogranin A (CgA) levels.^[1]
• Testing for elevated urinary 5-hydroxyindoleacetic acid (5-HIAA) has a specificity of approximately 88%, although the sensitivity is reported to be as low as 35%.
• Plasma levels of Chromogranin A (CgA) are very sensitive markers of carcinoid syndrome, but not specific as they are also elevated in other types of neuroendocrinae tumors such as pancreatic and small cell lung carcinomas.
• N-terminal pro–B-type natriuretic peptide : It is a useful biomarker of carcinoid heart disease at a cutoff level of 260 pg/ml (31 pmol/l).^[2]
• N-terminal pro–B-type natriuretic peptide used as a screening tool for carcinoid heart disease in patients with carcinoid syndrome.^[3]
• Other biochemical markers associated with carcinoid syndrome include:^[1]
  • Substance P
  • Neurotensin
  • Bradykinin
  • Human chorionic gonadotropin
  • Neuropeptide L
  • Pancreatic polypeptide

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