Is urinary 5-hydroxyindoleacetic acid helpful for early diagnosis of acute appendicitis?

Abstract

OBJECTIVE:

Acute appendicitis is the most common abdominal emergency in children and young adults. There are a lot of serotonin-containing cells in the appendix, which release serotonin into the bloodstream in response to inflammation. Consequently, serotonin is converted to 5-hydroxyindoleacetic acid (5-HIAA) and secreted into the urine. On this basis, urinary 5-HIAA could be a marker for acute appendicitis. In this study, we investigated the value of 5-HIAA levels in spot urine in the diagnosis of acute appendicitis.

METHODS:

The urinary 5-HIAA was measured by an enzyme-linked immunosorbent assay in the spot urine of 70 patients who presented to the emergency department with a clinical picture of acute appendicitis. Urine concentration results were correlated to final histopathologic reports, and the diagnostic value of this factor was measured.

RESULTS:

Diagnosis of appendicitis was confirmed by histopathologic reports in 59 of 70 patients with presumptive diagnosis of appendicitis. Considering 5.25 mg/L as the cutoff point for urinary 5-HIAA, 28 patients had high urinary 5-HIAA levels, whereas 42 patients had values within reference range. The sensitivity and specificity of this test was 44% and 81%, respectively.

CONCLUSIONS:

The measurement of urinary 5-HIAA levels is not an ideal diagnostic tool for ruling out or determination of acute appendicitis.

• Authors: Ali Jangjoo, Abdol-Reza Varasteh, Mostafa Mehrabi Bahar, Naser Tayyebi Meibodi, Habibollah Esmaili, Narges Nazeri, Mohsen Aliakbarian, Shahriar H Azizi
• Journal: The American journal of emergency medicine (Am J Emerg Med) Vol. 30 Issue 4 Pg. 540-4 (May 2012) ISSN: 1532-8171 [Electronic] United States
• PMID: 21450436 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2012 Elsevier Inc. All rights reserved.

Chemical References

• Biomarkers
• Hydroxyindoleacetic Acid

Topics

• Acute Disease
• Adolescent
• Adult
• Age Factors
• Appendicitis (diagnosis, urine)
• Biomarkers (urine)
• Child
• Double-Blind Method
• Early Diagnosis
• Enzyme-Linked Immunosorbent Assay
• Female
• Humans
• Hydroxyindoleacetic Acid (urine)
• Male
• Middle Aged
• Sensitivity and Specificity
• Young Adult