Chemical Pathology

Notes

Gut hormone levels are indicated in the investigation of patients with symptoms suggestive of a neuroendocrine tumour or for screening of patients with multiple endocrine neoplasia type I.

The profile includes the following gut hormones:

  • Gastrin
  • Glucagon
  • Pancreatic polypeptide
  • Vasoactive intestinal polypeptide
  • Somatostatin
  • Chromogranin A and B

Neurotensin and CART (cocaine- and amphetamine related transcript) no longer form part of the routine profile but are available in certain circumstances - please contact the Duty Biochemist if considered necessary.

Sample requirements

Patient preparation

The patient should have fasted for at least 10 hours prior to sampling.

Please list ALL current medication taken by the patient at the time of sampling. Please note problems with:

(i) Proton Pump Inhibitors: Omeprazole (Losec), Lansoprazole, Pantoprazole

If the patient is currently receiving Omeprazole therapy, Zollinger Ellison syndrome (ZES) cannot be diagnosed. This treatment has to stop for TWO WEEKS before submitting a fasting sample for assay.

(ii) H2 Antagonists: Ranitidine, Cimetidine, Famotidine, Nizatidine

When a gastrinoma is first suspected, it is at the discretion of the clinician whether or not to take the patient off treatment before testing for Gastrin. Should a fasting sample show a borderline or high level, it may be necessary to cease medication for 72 hours before repeating the screen.

Sample requirements

For adults 2 x 4mL pre-chilled EDTA tubes on ICE

EDTA with cap


Storage/transport

Do not store. Send immediately to the laboratory on ICE as the sample must be separated and plasma frozen within 15 minutes.

Required information

Relevant clinical details including current medication.

Turnaround times

Samples are sent to a referral laboratory for analysis, with results expected back within 4 weeks.

Reference ranges

Hormone Reference Range Units
Gastrin <40 pmol/L
Glucagon <50 pmol/L
PNCP (pancreatic polypeptide) <300 pmol/L
VIP (vasoactive intestinal polypeptide) <30 pmol/L
Somatostatin <150 pmol/L
Chromogranin A <60 pmol/L
Chromogranin B <150 pmol/L

Further information

To learn more access ENDOBIBLE on neuroendocrine tumours


Page last updated 22/02/2019

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