Vasoactive Intestinal Polypeptide (VIP), Plasma

CPT: 84586
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Special Instructions

Contact the Labcorp supply department for collection kit.


Expected Turnaround Time

4 - 9 days


Related Information


Related Documents


Specimen Requirements


Specimen

Plasma with Trasylol®, frozen


Volume

2 mL


Minimum Volume

0.4 mL (Note: This volume does not allow for repeat testing.)


Container

Lavender-top (EDTA) tube


Collection

Trasylol® kits may be ordered through the PeopleSoft system (Labcorp No. 33328). Using a chilled 6-mL lavender-top (EDTA) tube taken from the kit, collect a whole blood specimen. Mix the specimen several times by inverting the EDTA collection tube. After removing the cap from the EDTA draw tube, take one of the sterile, Beral pipettes (from under the gray foam), and add 0.25 mL Trasylol® to the EDTA tube. Recap the EDTA tube and invert several times to mix well. Centrifuge the EDTA tube to separate the plasma from the cells, and immediately transfer the plasma into one of the brown screw-cap transfer tubes provided in the kit. There should be a "Trasylol® Added" label affixed to the brown transfer tubes. Cap and freeze the labeled transfer tube containing the EDTA plasma with Trasylol® added. To avoid delays in turnaround time when requesting multiple test on frozen samples, please submit separate frozen specimens for each test requested.


Storage Instructions

Freeze.


Patient Preparation

Patient must not have received radioactive substances 24 hours prior to test.


Causes for Rejection

Sample not collected with Trasylol®; sample not submitted in tube with Trasylol label, gross hemolysis; recently administered radioisotopes; specimen not received frozen; serum, sodium citrate, or heparinized plasma specimen; lipemia


Test Details


Use

This test is used to measure the level of vasoactive intestinal polypeptide (VIP) in plasma.


Limitations

Not all patients with the syndrome have increased VIP. Increased VIP can be found in healthy controls and in laxative abusers.

This test was developed and its performance characteristics determined by Labcorp. It has not been cleared or approved by the Food and Drug Administration.


Methodology

DiaSource radioimmunoassay


Reference Interval

0.0−58.8 pg/mL


Additional Information

Vasoactive intestinal polypeptide (VIP) is a neurohormone produced in the central nervous system as well as in the neurons of the gastrointestinal (GI), respiratory and urogenital tracts.1 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.2,3

VIP secreting tumors (VIPoma) is a rare functional neuroendocrine tumor that typically arises from pancreatic islet cells.4-10 The VIPoma syndrome is also known as Verner-Morrison syndrome, watery diarrhea, hypokalemia, and hypochlorhydria or achlorhydria (WDHA) syndrome, and pancreatic cholera syndrome.1 VIPomas are functional neuroendocrine tumors that secrete excessive amounts of VIP. VIPoma tumors present as sporadic, solitary pancreatic neoplasias with an estimated incidence of one in ten million individuals per year.11 Approximately five percent of VIPomas are associated with multiple endocrine neoplasia type I syndrome.12 Excessive VIP secretion produces a clinical syndrome characterized by refractory watery diarrhea, hypokalemia and achlorhydria. These symptoms, coupled with elevated plasma levels of VIP, are diagnostic. The majority of VIPomas are malignant and have already metastasized at the time of diagnosis.


Footnotes

1. Sandhu S, Jialal I. ViPoma. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan. 2022 Jun 21.29939520
2. Iwasaki M, Akiba Y, Kaunitz JD. Recent advances in vasoactive intestinal peptide physiology and pathophysiology: focus on the gastrointestinal system. F1000Res. 2019 Sep 12;8:F1000 Faculty Rev-1629.31559013
3. Vu JP, Larauche M, Flores M, et al. Regulation of Appetite, Body Composition, and Metabolic Hormones by Vasoactive Intestinal Polypeptide (VIP). J Mol Neurosci. 2015 Jun;56(2):377-387.25904310
4. Una Cidon E. Vasoactive intestinal peptide secreting tumour: An overview. World J Gastrointest Oncol. 2022 Apr 15;14(4):808-819.35582098
5. Schizas D, Mastoraki A, Bagias G, et al. Clinicopathological data and treatment modalities for pancreatic vipomas: a systematic review. J BUON. 2019 Mar-Apr;24(2):415-423.31127985
6. Ito T, Igarashi H, Jensen RT. Pancreatic neuroendocrine tumors: clinical features, diagnosis and medical treatment: advances. Best Pract Res Clin Gastroenterol. 2012 Dec;26(6):737-753.23582916
7. Jensen RT, Cadiot G, Brandi M, et al. ENETS Consensus Guidelines for the management of patients with digestive neuroendocrine neoplasms: functional pancreatic endocrine tumor syndromes. Neuroendocrinology. 2012;95(2):98-119.22261919
8. Halfdanarson TR, Rubin J, Farnell MB, Grant CS, Petersen GM. Pancreatic endocrine neoplasms: epidemiology and prognosis of pancreatic endocrine tumors. Endocr Relat Cancer. 2008 Jun;15(2):409-427.18508996
9. Ghaferi AA, Chojnacki KA, Long WD, Cameron JL, Yeo CJ. Pancreatic VIPomas: subject review and one institutional experience. J Gastrointest Surg. 2008 Feb;12(2):382-393.17510774
10. 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):1050-1055.9854582
11. Yao JC, Eisner MP, Leary C, et al. Population-based study of islet cell carcinoma. Ann Surg Oncol. 2007 Dec;14(12):3492-3500.17896148
12. Thompson R, Landry CS. Multiple endocrine neoplasia 1: a broad overview. Ther Adv Chronic Dis. 2021 Aug 12;12:20406223211035288.34413971

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
010397 VIP, Plasma 3125-2 010415 VIP, Plasma pg/mL 3125-2

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