Vasoactive Intestinal Polypeptide (VIP), Plasma

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Category:

Turnaround Time: 4 - 9 days
CPT Code:

84586

Test Type: 2 mL Plasma with Trasylol®, frozen
Reference Range:

0.0-58.8 pg/mL

Overview:

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.

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.

Other features of some cases of VIPoma have included hypercalcemia, flushing, and glucose intolerance.1 A study of islet cell tumors in patients with multiple endocrine neoplasia (MEN) included vasoactive intestinal polypeptide tumor (VIPoma) as well as Zollinger-Ellison syndrome and insulinoma.2 A VIP-producing tumor causing the pancreatic cholera syndrome was reported as a well differentiated mucinous adenocarcinoma which contained cells reactive for pancreatic peptide and VIP on immunocytochemistry.3 Normal levels of VIP have been reported in ulcerative colitis, Crohn's disease, cirrhosis, ascites, and diabetes.

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. PubMed 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. PubMed 2828145

Basson MD, Fielding LP, Bilchik AJ, et al. Does vasoactive intestinal polypeptide mediate the pathophysiology of bowel obstruction? Am J Surg. 1989 Dec; 157(1):109-114. PubMed 2910115

Deveney CW, Way LW. Regulatory peptides of the gut. In Greenspan FS, Forsham PH, eds. Basic and Clinical Endocrinology. 3rd ed. Los Altos, Calif: Lange Medical Publications; 1991: 569-591.

Fahrenkrug J, Emson PC. Vasoactive intestinal polypeptide: Functional aspects. Br Med Bull. 1982 Sep; 38(3):265-270 (review). PubMed 6129023

Fraker DL, Norton JA. The role of surgery in the management of islet cell tumors. Gastroenterol Clin North Am. 1989 Dec; 18(4):805-830. PubMed 2559034

Green DW, Gómez G, Greeley GH Jr. Gastrointestinal peptides. Gastroenterol Clin North Am. 1989 Dec; 18(4):695-733. PubMed 2693350

Jaffe BM. The diarrheogenic syndrome: Werner-Morrison, WDHA syndrome. In: Friesen SR, Bolinger RE, eds. Surgical Endocrinology. Philadelphia, Pa: JB Lippincott Co; 1978: 219-221.

Said SI. Vasoactive intestinal polypeptide (VIP): Current status. Peptides. 1984 Mar-Apr; 5(2):143-150 (review). PubMed 6147814

Collection Details:

Patient Preparation:

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

Collection Instructions:

Lavender-top (EDTA) tube.

Trasylol® kits may be ordered through the PeopleSoft system (LabCorp 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.

Freeze.