{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T07:55:06Z","timestamp":1791100506460,"version":"4.1.0"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2004,9,1]],"date-time":"2004-09-01T00:00:00Z","timestamp":1093996800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2004,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Background: Vasoactive peptides produced by neuroendocrine tumors can induce characteristic symptoms of the carcinoid syndrome (flushing, diarrhea, and wheezing). To what extent external factors provoke these symptoms and how excretion of 5-hydroxyindoleacetic acid (5-HIAA), the degradation product of serotonin, varies throughout the day remain unknown. In this study, we investigated whether symptoms and daily activity are related to 5-HIAA excretion and whether 24-h urine collection is needed.<\/jats:p><jats:p>Methods: In 26 patients with metastatic carcinoid (14 men and 12 women; median age, 60 years) urine was collected in portions of 4 or 8 h during 2 days. Patients were asked to keep a diary in which they noted symptoms of flushes, consistency of stools, activities, and food intake.<\/jats:p><jats:p>Results: Excretion of 5-HIAA in 24-h urine was increased in 88% of the patients (median, 515 \u03bcmol\/24 h). Overnight-collected urine appeared the most representative for 24-h collection concentrations (correlation coefficient = 0.81). We found no clear correlation between symptoms of the carcinoid syndrome and degree of activity. Watery diarrhea was reported only by patients with strong variations in 5-HIAA excretion. One-half of the patients (n = 16) exhibited a high variability in urinary 5-HIAA excretion throughout the day, with increased concentrations most prominent in morning collections (P = 0.0074) and lower concentrations in the evening (P = 0.0034). In the other patients these curves were flat.<\/jats:p><jats:p>Conclusions: Cyclic changes in patients relate to high variability in 5-HIAA excretion. Overnight-collected urine can replace the 24-h urine collection, and marked variations in 5-HIAA excretion seem to be associated with severity of diarrhea.<\/jats:p>","DOI":"10.1373\/clinchem.2004.032151","type":"journal-article","created":{"date-parts":[[2004,7,10]],"date-time":"2004-07-10T01:06:37Z","timestamp":1089421597000},"page":"1634-1639","source":"Crossref","is-referenced-by-count":32,"title":["Daily Cyclic Changes in the Urinary Excretion of 5-Hydroxyindoleacetic Acid in Patients with Carcinoid Tumors"],"prefix":"10.1093","volume":"50","author":[{"given":"Johanna M","family":"Zuetenhorst","sequence":"first","affiliation":[{"name":"Departments of Gastroenterology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catharina M","family":"Korse","sequence":"first","affiliation":[{"name":"Clinical Chemistry, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes M G","family":"Bonfrer","sequence":"first","affiliation":[{"name":"Clinical Chemistry, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen","family":"Peter","sequence":"first","affiliation":[{"name":"Statistics, Netherlands Cancer Institute\/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cornelis B H W","family":"Lamers","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Babs G","family":"Taal","sequence":"first","affiliation":[{"name":"Departments of Gastroenterology"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2004,9,1]]},"reference":[{"key":"2020030122224594300_R1","doi-asserted-by":"crossref","first-page":"1295","DOI":"10.1023\/A:1012272314550","volume":"12","year":"2001","journal-title":"Ann Oncol"},{"key":"2020030122224594300_R2","doi-asserted-by":"crossref","first-page":"1609","DOI":"10.1002\/cncr.11226","volume":"97","year":"2003","journal-title":"Cancer"},{"key":"2020030122224594300_R3","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1056\/NEJM195907232610406","volume":"261","year":"1959","journal-title":"N Engl J Med"},{"key":"2020030122224594300_R4","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1056\/NEJM195907022610104","volume":"261","year":"1959","journal-title":"N Engl J Med"},{"key":"2020030122224594300_R5","first-page":"159","year":"1958","journal-title":"Lancet"},{"key":"2020030122224594300_R6","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/0024-3205(95)00269-C","volume":"57","year":"1995","journal-title":"Life Sci"},{"key":"2020030122224594300_R7","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1056\/NEJM199903183401107","volume":"340","year":"1999","journal-title":"N Engl J Med"},{"key":"2020030122224594300_R8","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/0002-9343(86)90583-8","volume":"81","year":"1986","journal-title":"Am J Med"},{"key":"2020030122224594300_R9","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1016\/0016-5085(95)90447-6","volume":"108","year":"1995","journal-title":"Gastroenterology"},{"key":"2020030122224594300_R10","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.3109\/00365528708991954","volume":"22","year":"1987","journal-title":"Scand J Gastroenterol"},{"key":"2020030122224594300_R11","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1016\/0016-5085(86)90630-X","volume":"91","year":"1986","journal-title":"Gastroenterology"},{"key":"2020030122224594300_R12","doi-asserted-by":"crossref","first-page":"1417","DOI":"10.1136\/gut.28.11.1417","volume":"28","year":"1987","journal-title":"Gut"},{"key":"2020030122224594300_R13","doi-asserted-by":"crossref","first-page":"1834","DOI":"10.1093\/clinchem\/36.10.1834","volume":"36","year":"1990","journal-title":"Clin Chem"},{"key":"2020030122224594300_R14","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1016\/S0021-9258(19)81408-4","volume":"216","year":"1955","journal-title":"J Biol Chem"},{"key":"2020030122224594300_R15","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1093\/clinchem\/19.1.38","volume":"19","year":"1973","journal-title":"Clin Chem"},{"key":"2020030122224594300_R16","first-page":"1057","volume":"40","year":"1994","journal-title":"Clin Chem"},{"key":"2020030122224594300_R17","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1056\/NEJMoa021451","volume":"348","year":"2003","journal-title":"N Engl J Med"},{"key":"2020030122224594300_R18","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1177\/000456328702400209","volume":"24","year":"1987","journal-title":"Ann Clin Biochem"},{"key":"2020030122224594300_R19","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1016\/0049-3848(91)90123-E","volume":"64","year":"1991","journal-title":"Thromb Res"},{"key":"2020030122224594300_R20","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/0009-8981(93)90029-4","volume":"221","year":"1993","journal-title":"Clin Chim Acta"},{"key":"2020030122224594300_R21","first-page":"209","volume":"66","year":"2000","journal-title":"Life Sci"},{"key":"2020030122224594300_R22","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1210\/jcem-68-4-796","volume":"68","year":"1989","journal-title":"J Clin Endocrinol Metab"},{"key":"2020030122224594300_R23","first-page":"905","volume":"186","year":"1963","journal-title":"JAMA"},{"key":"2020030122224594300_R24","doi-asserted-by":"crossref","first-page":"1413","DOI":"10.1136\/gut.28.11.1413","volume":"28","year":"1987","journal-title":"Gut"}],"container-title":["Clinical Chemistry"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/clinchem\/article-pdf\/50\/9\/1634\/32730129\/clinchem1634.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/clinchem\/article-pdf\/50\/9\/1634\/32730129\/clinchem1634.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,6,24]],"date-time":"2021-06-24T04:38:27Z","timestamp":1624509507000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/clinchem\/article\/50\/9\/1634\/5639971"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2004,9,1]]},"references-count":24,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2004,9,1]]},"published-print":{"date-parts":[[2004,9,1]]}},"URL":"https:\/\/doi.org\/10.1373\/clinchem.2004.032151","relation":{},"ISSN":["0009-9147","1530-8561"],"issn-type":[{"value":"0009-9147","type":"print"},{"value":"1530-8561","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2004,9,1]]},"published":{"date-parts":[[2004,9,1]]}}}