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Epic Code LAB10164 Vasoactive Intestinal Polypeptide, Plasma

Important Note

Fasting specimen required (8 hours)

Additional Codes

Mayo Code: VIP

Epic Code: LAB 10164

Cerner Code: 4110

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Useful For

Detection of vasoactive intestinal polypeptide producing tumors in patients with chronic diarrheal diseases

Specimen Type

Plasma EDTA


Ordering Guidance


This test should not be requested on patients who have recently received radioactive material.



Specimen Required


Patient Preparation: Fasting (8 hours)

Collection Container/Tube: Lavender top (EDTA)

Submission Container/Tube: Plastic vial

Specimen Volume: 1 mL

Collection Instructions: Centrifuge and freeze immediately.


Laboratory Test Directory Note:

COLLECTION NOTE: Volumes listed are in serum or plasma, draw approximately 2 1/2 times the requested volume in whole blood.

Specimen Minimum Volume

0.55 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Plasma EDTA Frozen 90 days

Reject Due To

Gross hemolysis Reject
Gross lipemia Reject
Gross icterus OK

Cautions

This test should not be requested in patients who have recently received radioisotopes, therapeutically or diagnostically, because of potential assay interference. A recommended time period before collection cannot be made because it will depend on the isotope administered, the dose given and the clearance rate in the individual patient. Specimens will be screened for radioactivity prior to analysis. Radioactive samples received in the laboratory will be held and assayed after the radioactivity has sufficiently decayed. This will result in a test delay.

Clinical Information

Vasoactive intestinal polypeptide (VIP) was originally isolated from porcine small intestine and was recognized by its potent vasodilator activity. This brain/gut hormone has widespread distribution and is present in neuronal cell bodies localized in the central nervous system, digestive, respiratory, and urogenital tracts, and exocrine, thyroid, and adrenal glands. VIP has a wide scope of biological actions. The main effects of VIP include relaxation of smooth muscle (bronchial and vascular dilation), stimulation of gastrointestinal water and electrolyte secretion, and release of pancreatic hormones.

 

VIP-producing tumors (VIPomas) are rare; most (90%) are located in the pancreas. Watery diarrhea, hypokalemia, and achlorhydria are key symptoms.

Method Name

Radioimmunoassay (RIA)

Report Available

4 to 8 days

Reporting Name

Vasoactive Intestinal Polypeptide,P

Reference Values

<75 pg/mL

Interpretation

Values above 75 pg/mL may indicate the presence of an enteropancreatic tumor causing hypersecretion of vasoactive intestinal polypeptide (VIP).

 

Values above 200 pg/mL are strongly suggestive of VIP-producing tumors (VIPoma).

 

VIPoma is unlikely with a 24-hour stool volume below 700 mL.

Method Description

Vasoactive intestinal polypeptide (VIP) in the patient sample competes with labeled ([125]I) VIP for a limited number of primary antibody binding sites during a 24-hour incubation. Antibody-bound VIP is separated from the unbound portion by a goat anti-rabbit secondary antibody. Centrifugation brings down the heavy antibody complexes while unbound antigen remains in solution and is discarded. The amount of labeled antigen bound to the antibody is inversely proportional to the amount of VIP present in the patient sample. The (125)I signal is counted on a gamma counter and the counts per minute are used to calculate percent of maximum binding and construct a standard curve.(Unpublished Mayo method)

Day(s) Performed

Monday, Tuesday, Wednesday

Clinical Reference

1. Smith SL, Branton SA, Avino AJ, et al: Vasoactive intestinal polypeptide secreting islet cell tumors: a 15-year experience and review of the literature. Surgery 1998 Dec;124(6):1050-1055 (Review)

2. Ghaferi AA, Chojnacki KA, Long WD, et al: Pancreatic VIPomas: subject review and one institutional experience. J Gastrointest Surg 2008 Feb;12(2):382-393

3 Eisenhofer G, Grebe S, Cheung NK, et al: Ch 63 Monoamine-Producing Tumors. In Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. Sixth edition. Edited by N Rafai, AR Horvath, CT Wittwer. Elsevier, 2018, pp 1421

Test Classification

This test was developed, and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

84586

LOINC Code Information

Test ID Test Order Name Order LOINC Value
VIP Vasoactive Intestinal Polypeptide,P 3125-2

 

Result ID Test Result Name Result LOINC Value
8150 Vasoactive Intestinal Polypeptide,P 3125-2