Pseudo‐hyperglucagonemia was observed in pancreatectomized patients when measured by glucagon sandwich enzyme‐linked immunosorbent assay

Glucagon is detected in plasma even after total pancreatectomy, and it is debated whether this glucagon is derived from the gastrointestinal tract. Here, we applied sandwich enzyme‐linked immunosorbent assay (ELISA) and liquid chromatography–high‐resolution mass spectrometry to measure plasma glucagon levels in one patient after partial pancreatectomy (one‐seventh of the pancreas remaining) and three patients after total pancreatectomy. Sandwich ELISA detected higher glucagon levels in pancreatectomy patients than in healthy individuals. In contrast, liquid chromatography–high‐resolution mass spectrometry showed that plasma glucagon levels in pancreatectomy patients were below the lower limit of quantification. Plasma glucagon measured by sandwich ELISA showed a striking correlation with plasma glicentin, suggesting cross‐reaction with this gastrointestinal glucagon‐related peptide. These results indicated that pancreatectomized patients falsely showed pseudo‐hyperglucagonemia when measured by glucagon sandwich ELISA.