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Frequency and Causes of False-Positive Elevated Plasma Concentrations of Fasting Gut Hormones in a Specialist Neuroendocrine Tumor Center
INTRODUCTION: In the UK, the fasting plasma concentrations of a panel of gut hormones (comprising vasoactive intestinal peptide (VIP), gastrin, pancreatic polypeptide (PP), glucagon, somatostatin and chromogranin A) are measured to evaluate patients who have or who (due to unexplained and compatible...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2020
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7774602/ https://www.ncbi.nlm.nih.gov/pubmed/33391185 http://dx.doi.org/10.3389/fendo.2020.606264 |
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author | Butler, Olivia L. Mekhael, Monica M. Ahmed, Arslan Cuthbertson, Daniel J. Pritchard, D. Mark |
author_facet | Butler, Olivia L. Mekhael, Monica M. Ahmed, Arslan Cuthbertson, Daniel J. Pritchard, D. Mark |
author_sort | Butler, Olivia L. |
collection | PubMed |
description | INTRODUCTION: In the UK, the fasting plasma concentrations of a panel of gut hormones (comprising vasoactive intestinal peptide (VIP), gastrin, pancreatic polypeptide (PP), glucagon, somatostatin and chromogranin A) are measured to evaluate patients who have or who (due to unexplained and compatible symptoms) are suspected of having neuroendocrine tumors (NETs). False positive elevated hormone concentrations are sometimes found. OBJECTIVE: To evaluate the frequency and implications of false positive fasting gut hormone results. METHODS: Retrospective audit of fasting gut hormone profile results at a large UK university teaching hospital over 12 months. RESULTS: Fasting gut hormone concentrations were measured in 231 patients during 2017. No NETs were found in the 88 patients who had this test performed only to investigate symptoms. 31 false positive gastrin, 8 false positive chromogranin A, two false positive glucagon, three false positive somatostatin, one false positive PP, and one false positive VIP results were found. We extended the audit for glucagon and somatostatin for an additional two years and found seven probable false-positive raised glucagon concentrations and four probable false-positive elevated plasma somatostatin concentrations in total. CONCLUSIONS: False-positive elevations of plasma gastrin and chromogranin A were common and causes such as proton pump inhibitor use or inadequate fasting accounted for most cases. Elevated plasma concentrations of the other gut hormones were also detected in patients who had no other evidence of NET. Other diagnoses (e.g. cirrhosis and medullary thyroid carcinoma for hypersomatostatinemia and type 2 diabetes mellitus, pancreatitis, liver or renal impairment for hyperglucagonemia) may cause these false positive results. |
format | Online Article Text |
id | pubmed-7774602 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-77746022021-01-01 Frequency and Causes of False-Positive Elevated Plasma Concentrations of Fasting Gut Hormones in a Specialist Neuroendocrine Tumor Center Butler, Olivia L. Mekhael, Monica M. Ahmed, Arslan Cuthbertson, Daniel J. Pritchard, D. Mark Front Endocrinol (Lausanne) Endocrinology INTRODUCTION: In the UK, the fasting plasma concentrations of a panel of gut hormones (comprising vasoactive intestinal peptide (VIP), gastrin, pancreatic polypeptide (PP), glucagon, somatostatin and chromogranin A) are measured to evaluate patients who have or who (due to unexplained and compatible symptoms) are suspected of having neuroendocrine tumors (NETs). False positive elevated hormone concentrations are sometimes found. OBJECTIVE: To evaluate the frequency and implications of false positive fasting gut hormone results. METHODS: Retrospective audit of fasting gut hormone profile results at a large UK university teaching hospital over 12 months. RESULTS: Fasting gut hormone concentrations were measured in 231 patients during 2017. No NETs were found in the 88 patients who had this test performed only to investigate symptoms. 31 false positive gastrin, 8 false positive chromogranin A, two false positive glucagon, three false positive somatostatin, one false positive PP, and one false positive VIP results were found. We extended the audit for glucagon and somatostatin for an additional two years and found seven probable false-positive raised glucagon concentrations and four probable false-positive elevated plasma somatostatin concentrations in total. CONCLUSIONS: False-positive elevations of plasma gastrin and chromogranin A were common and causes such as proton pump inhibitor use or inadequate fasting accounted for most cases. Elevated plasma concentrations of the other gut hormones were also detected in patients who had no other evidence of NET. Other diagnoses (e.g. cirrhosis and medullary thyroid carcinoma for hypersomatostatinemia and type 2 diabetes mellitus, pancreatitis, liver or renal impairment for hyperglucagonemia) may cause these false positive results. Frontiers Media S.A. 2020-12-16 /pmc/articles/PMC7774602/ /pubmed/33391185 http://dx.doi.org/10.3389/fendo.2020.606264 Text en Copyright © 2020 Butler, Mekhael, Ahmed, Cuthbertson and Pritchard http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Endocrinology Butler, Olivia L. Mekhael, Monica M. Ahmed, Arslan Cuthbertson, Daniel J. Pritchard, D. Mark Frequency and Causes of False-Positive Elevated Plasma Concentrations of Fasting Gut Hormones in a Specialist Neuroendocrine Tumor Center |
title | Frequency and Causes of False-Positive Elevated Plasma Concentrations of Fasting Gut Hormones in a Specialist Neuroendocrine Tumor Center |
title_full | Frequency and Causes of False-Positive Elevated Plasma Concentrations of Fasting Gut Hormones in a Specialist Neuroendocrine Tumor Center |
title_fullStr | Frequency and Causes of False-Positive Elevated Plasma Concentrations of Fasting Gut Hormones in a Specialist Neuroendocrine Tumor Center |
title_full_unstemmed | Frequency and Causes of False-Positive Elevated Plasma Concentrations of Fasting Gut Hormones in a Specialist Neuroendocrine Tumor Center |
title_short | Frequency and Causes of False-Positive Elevated Plasma Concentrations of Fasting Gut Hormones in a Specialist Neuroendocrine Tumor Center |
title_sort | frequency and causes of false-positive elevated plasma concentrations of fasting gut hormones in a specialist neuroendocrine tumor center |
topic | Endocrinology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7774602/ https://www.ncbi.nlm.nih.gov/pubmed/33391185 http://dx.doi.org/10.3389/fendo.2020.606264 |
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