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An unusual case of proton pump inhibitor induced hyperchromograninemia

Objective: To describe an unusual case of symptomatic hyperchromograninemia associated with proton pump inhibitor (PPI) use. Case Summary: A 55-year-old man with stage 1 follicular lymphoma and GERD on omeprazole presented with symptoms suggesting carcinoid syndrome. The only positive finding on wor...

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Autores principales: Adu-Gyamfi, Kwabena Oware, Gyamfi, Richmond, Patri, Sandeep
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Taylor & Francis 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6968679/
https://www.ncbi.nlm.nih.gov/pubmed/32002161
http://dx.doi.org/10.1080/20009666.2019.1682748
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author Adu-Gyamfi, Kwabena Oware
Gyamfi, Richmond
Patri, Sandeep
author_facet Adu-Gyamfi, Kwabena Oware
Gyamfi, Richmond
Patri, Sandeep
author_sort Adu-Gyamfi, Kwabena Oware
collection PubMed
description Objective: To describe an unusual case of symptomatic hyperchromograninemia associated with proton pump inhibitor (PPI) use. Case Summary: A 55-year-old man with stage 1 follicular lymphoma and GERD on omeprazole presented with symptoms suggesting carcinoid syndrome. The only positive finding on workup was a markedly elevated level of chromogranin A and no carcinoid tumor was identified. Omeprazole was discontinued, following which his symptoms resolved and chromogranin A levels returned to normal. To the best of our knowledge, no symptoms have been previously reported in association with PPI-induced hyperchromograninemia. Discussion: The reliability of chromogranin A as a marker for neuroendocrine tumors is of growing concern. The reasons for the associated symptomatology in this case are unclear but could involve physiologic effects of chromogranin A breakdown products. The role of pharmacogenomics in PPI metabolism is discussed as a potential explanation for the significant hyperchromograninemia. Conclusion: The phenomenon of PPI-induced hyperchromograninemia is highlighted for providers especially in the context of neuroendocrine tumor diagnosis and surveillance. The need for more research into chromogranins is proposed.
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spelling pubmed-69686792020-01-30 An unusual case of proton pump inhibitor induced hyperchromograninemia Adu-Gyamfi, Kwabena Oware Gyamfi, Richmond Patri, Sandeep J Community Hosp Intern Med Perspect Case Report Objective: To describe an unusual case of symptomatic hyperchromograninemia associated with proton pump inhibitor (PPI) use. Case Summary: A 55-year-old man with stage 1 follicular lymphoma and GERD on omeprazole presented with symptoms suggesting carcinoid syndrome. The only positive finding on workup was a markedly elevated level of chromogranin A and no carcinoid tumor was identified. Omeprazole was discontinued, following which his symptoms resolved and chromogranin A levels returned to normal. To the best of our knowledge, no symptoms have been previously reported in association with PPI-induced hyperchromograninemia. Discussion: The reliability of chromogranin A as a marker for neuroendocrine tumors is of growing concern. The reasons for the associated symptomatology in this case are unclear but could involve physiologic effects of chromogranin A breakdown products. The role of pharmacogenomics in PPI metabolism is discussed as a potential explanation for the significant hyperchromograninemia. Conclusion: The phenomenon of PPI-induced hyperchromograninemia is highlighted for providers especially in the context of neuroendocrine tumor diagnosis and surveillance. The need for more research into chromogranins is proposed. Taylor & Francis 2019-12-14 /pmc/articles/PMC6968679/ /pubmed/32002161 http://dx.doi.org/10.1080/20009666.2019.1682748 Text en © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group on behalf of Greater Baltimore Medical Center. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Adu-Gyamfi, Kwabena Oware
Gyamfi, Richmond
Patri, Sandeep
An unusual case of proton pump inhibitor induced hyperchromograninemia
title An unusual case of proton pump inhibitor induced hyperchromograninemia
title_full An unusual case of proton pump inhibitor induced hyperchromograninemia
title_fullStr An unusual case of proton pump inhibitor induced hyperchromograninemia
title_full_unstemmed An unusual case of proton pump inhibitor induced hyperchromograninemia
title_short An unusual case of proton pump inhibitor induced hyperchromograninemia
title_sort unusual case of proton pump inhibitor induced hyperchromograninemia
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6968679/
https://www.ncbi.nlm.nih.gov/pubmed/32002161
http://dx.doi.org/10.1080/20009666.2019.1682748
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