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False-Positive Tests for Urinary 5-Hydroxyindoleacetic Acid: Title and subTitle BreakError in Laboratory Determinations Caused by Glyceryl Guaiacolate FREE

Arthur T. Pedersen, MD; John G. Batsakis, MD; Neal A. Vanselow, MD; James A. McLean, MD
[+] Author Affiliations

Reprint requests to 1405 E Ann St, Ann Arbor, Mich 48104 (Dr. Pedersen).


JAMA. 1970;211(7):1184-1186. doi:10.1001/jama.1970.03170070054016
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A metabolic by-product of glyceryl guaiacolate, a widely used expectorant, causes a false-positive increase in urinary 5-hydroxyindoleacetic acid (5-HIAA) in laboratory tests. This interference may result in confusion during evaluation of patients for the carcinoid syndrome. This problem of false-positive test results is particularly relevant to asthmatic patients, who are frequently on a regimen of compounds which contain glyceryl guaiacolate. On occasion, particularly when they have abdominal distress and diarrhea, asthmatics may be evaluated for the carcinoid syndrome. In such instances, discontinuation of glyceryl guaiacolate for 24 hours before the collection of 24-hour urine specimens for 5-HIAA determination is recommended.

REFERENCES

Udenfriend, S.; Titus, E.; and Weissbach, H.:  The Identification of 5-Hydroxy-3-Indoleacetic Acid in Normal Urine and a Method for its Assay , J Biol Chem 216:499-505 ( (Oct) ) 1955;.
Sjoerdsma, A.:  Clinical and Laboratory Features of Malignant Carcinoid , Arch Intern Med 102:936-938 ( (Dec) ) 1958;.
Elking, M.P., and Kabat, H.F.:  Drug Induced Modifications of Laboratory Test Values , Amer J Hosp Pharm 25:485-519 ( (Sept) ) 1968;.
Cross, F. C.; Canada, A.T.; and Davis, N.H.:  The Effect of Certain Drugs on the Results of Some Common Laboratory Diagnostic Procedures , Amer J Hosp Pharm 23:234-239 ( (May) ) 1966;.
Meyers, F.H.: Jawitz, E.: and Goldfein, A: Review of Medical Pharmacology , Los Altos, Calif: Lange Publications, 1968;.
Writh, W.A. and Thompson, R.L.:  The Effect of Various Conditions and Substances on the Results of Laboratory Procedures , Amer J Clin Path 43:579-590 ( (June) ) 1965;.
Honet, J.C.; Casey, T.V.; and Runyan, J.W.:  False-Positive Urinary Test for 5-Hydroxyindoleacetic Acid Due to Methocarbamol and Mephenesin Carbamate , New Eng J Med 261:188-190 ( (July 23) ) 1959;.
Shils, M.E.:  Interference by Formaldehydogenic Drugs in Quantitative Determination of Urinary Hydroxyindoleacetic Acid , Clin Chem 13:397-405 ( (May) ) 1967;.
Ross, G.; Weinstein, I.B.; and Kabakow, B.:  The Interference of Phenothiazine and Some of its Derivatives on the Determination of 5-Hydroxyindoleacetic Acid , Clin Chem 4:66-76 ( (Feb) ) 1958;.

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Udenfriend, S.; Titus, E.; and Weissbach, H.:  The Identification of 5-Hydroxy-3-Indoleacetic Acid in Normal Urine and a Method for its Assay , J Biol Chem 216:499-505 ( (Oct) ) 1955;.
Sjoerdsma, A.:  Clinical and Laboratory Features of Malignant Carcinoid , Arch Intern Med 102:936-938 ( (Dec) ) 1958;.
Elking, M.P., and Kabat, H.F.:  Drug Induced Modifications of Laboratory Test Values , Amer J Hosp Pharm 25:485-519 ( (Sept) ) 1968;.
Cross, F. C.; Canada, A.T.; and Davis, N.H.:  The Effect of Certain Drugs on the Results of Some Common Laboratory Diagnostic Procedures , Amer J Hosp Pharm 23:234-239 ( (May) ) 1966;.
Meyers, F.H.: Jawitz, E.: and Goldfein, A: Review of Medical Pharmacology , Los Altos, Calif: Lange Publications, 1968;.
Writh, W.A. and Thompson, R.L.:  The Effect of Various Conditions and Substances on the Results of Laboratory Procedures , Amer J Clin Path 43:579-590 ( (June) ) 1965;.
Honet, J.C.; Casey, T.V.; and Runyan, J.W.:  False-Positive Urinary Test for 5-Hydroxyindoleacetic Acid Due to Methocarbamol and Mephenesin Carbamate , New Eng J Med 261:188-190 ( (July 23) ) 1959;.
Shils, M.E.:  Interference by Formaldehydogenic Drugs in Quantitative Determination of Urinary Hydroxyindoleacetic Acid , Clin Chem 13:397-405 ( (May) ) 1967;.
Ross, G.; Weinstein, I.B.; and Kabakow, B.:  The Interference of Phenothiazine and Some of its Derivatives on the Determination of 5-Hydroxyindoleacetic Acid , Clin Chem 4:66-76 ( (Feb) ) 1958;.
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