Vasoactive Intestinal Polypeptide (VIP), Plasma

TEST: 010397

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CPT: 84586

Updated on 11/6/2022

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Special Instructions

Contact the Labcorp supply department for collection kit.

Contact ~~the LabC~~orp supply department for collection kit.

Contact the Labcorp supply department for collection kit.

Expected Turnaround Time

4 - 9 days

Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.

Related Information

Pancreatic Polypeptide

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.

Trasylol® kits may be ordered through the PeopleSoft system (Lab~~Corp N°~~ 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

Measurement of the level of vasoactive intestinal polypeptide (VIP) in serum

Hypersecretion of VIP is observed in “pancreatic cholera syndrome,” Verner-Morrison syndrome or the watery diarrhea-hypokalemia-hypochlorhydria (WDHH) syndrome. It is characterized by hypermotility, watery diarrhea syndromes with hypokalemia and hypochlorhydria, dehydration and weakness; these symptoms can be reproduced by VIP. VIP can be secreted by pancreatic or ectopic islet cell tumors, and in islet-cell hyperplasia.

Measurement of the level of vasoactive intestinal polypeptide (VIP) in serum

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.

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

Results for this test are for research purposes only by the assay's manufacturer. The performance characteristics of this product have not been established. Results should not be used as a diagnostic procedure without confirmation of the diagnosis by another medically established diagnostic product or procedure.

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

~~Radioimmunoassay (RIA)~~

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.^4-10The 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

1. ~~Krejs GJ. Noninsulin-secreting tumors of the pancreatic islets. In: Wilson JD, Foster DW, eds. Williams Textbook of Endocrinology. 8th ed. Philadelphia, Pa: WB Saunders Co; 1992: 1567-1576.~~

2. Sheppard BC, Norton JA, Doppman JL, et al. Management of islet cell tumors in patients with multiple endocrine neoplasia: A prospective study. Surgery. 1989; 106(6):1108-1118. 2573957

3. Rood RP, DeLellis RA, Dayal Y, et al. Pancreatic cholera syndrome due to a vasoactive intestinal polypeptide-producing tumor: Further insights into the pathophysiology. Gastroenterology. 1988; 94(3):813-818. 2828145