Monitoring the treatment of carcinoid disease using blood serotonin and plasma 5-hydroxyindoleacetic acid: three case examples.
The results for plasma 5-hydroxyindoleacetic acid (5-HIAA), whole blood serotonin and the chromogranins on three patients following their treatment for carcinoid disease with somatostatin analogues are presented. Two of the patients (a 56-year-old woman and a 55-year-old man) demonstrated a good clinical response following treatment, with initial high blood serotonin and plasma 5-HIAA concentrations showing a significant decline. However, blood serotonin concentrations remained above the reference range during the course of treatment, whereas plasma 5-HIAA remained borderline high or marginally elevated with respect to the clinical cut-off concentration. The third patient, a 79-year-old man, demonstrated saturation of platelets with serotonin and increasing elevation of plasma 5-HIAA, which later fell with the introduction of interferon into this patient's treatment regimen. Results for the plasma chromogranin fragments, pancreastatin (Chromogranin A) and GAWK (Chromogranin B), showed a much greater degree of variability in all three cases. This study shows promise for plasma 5-HIAA as a useful marker for monitoring carcinoid disease. The limitations of blood serotonin expressed to the platelet count are highlighted.
Allen
K R
KR
Department of Clinical Biochemistry, Leeds Teaching Hospitals, Britannia House, Morley, Leeds LS27 0DQ, UK. keith.allen@leedsth.nhs.uk
Degg
T J
TJ
Anthoney
D A
DA
Fitzroy-Smith
D
D
D000368:Aged; D002276:Carcinoid Tumor / Q000097:blood / Q000188:drug therapy*; D006801:Humans; D006897:Hydroxyindoleacetic Acid / Q000097:blood*; D016898:Interferon-alpha / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012701:Serotonin / Q000097:blood*; D013004:Somatostatin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use
D016898:Interferon-alpha; D012701:Serotonin; D013004:Somatostatin; D006897:Hydroxyindoleacetic Acid