Chromogranin A as a useful neuroendocrine marker in patients with autoimmune Addison's disease.
BACKGROUND
Antiparietal cells antibodies (APC-Ab) are commonly found in patients with autoimmune Addison's disease (AAD), usually pointing to autoimmune atrophic gastritis and pernicious anemia. The autoaggression to the gastric proton pumpmay result in a long-term hypergastrinemia, which predisposes to enterochromaffin-like cell hyper/dysplasia and gastric carcinoids.


OBJECTIVE
We evaluated the clinical utility of assessing serum chromogranin A levels in patients with AAD.


METHODS
Serum chromogranin A, gastrin, and gastric APC-Ab levels were determined in 40 patients with AAD using commercially available kits.


RESULTS
Serum chromogranin A and gastrin levels were found to be elevated in 27.5 and 22.5% of patients with AAD, respectively. The Addison's patients with elevated APC-Ab had significantly higher chromogranin A and gastrin levels, as compared to individuals with normal APC-Ab (chromogranin A: 128.00+/-123.08 vs 57.68+/-36.50 ng/ml, p=0.0036; gastrin: 141.38+/-191.43 vs 49.50+/-75.36 muU/ml, p=0.003). Additionally, the patients with AAD and coexisting elevated serum APC-Ab, contrary to those with normal levels, showed a significant correlation between the chromogranin A and gastrin concentrations (r=0.52, p=0.0092 vs r=0.211, p=0.43). Serum chromogranin A appeared also significantly correlated with APC-Ab levels (r=0.431, p=0.005).


CONCLUSIONS
In patients with autoimmune Addison's disease hyperchromograninemia and hypergastrinemia occur with a prevalence of 27.5 and 22.5%, respectively. Addison's patients with coexisting elevated gastric APC-Ab, particularly with elevated gastrin levels, are at risk of enterochromaffin-like cells hyper/dysplasia. Serum chromogranin A assessment may complement histology for the early diagnosis of gastric carcinoid in these patients.
Department of Internal Diseases, Metabolic Disorders and Dietetics, Poznan University of Medical Sciences, 60-355 Poznan, Poland. zio73@poczta.fm
Z
Z
El Ali
M
M
Fichna
J
J
Piniewska
J
J
Kosowicz
M
M
Grzymisławski
D000224:Addison Disease / Q000097:blood*; D000328:Adult; D000368:Aged; D001327:Autoimmune Diseases / Q000097:blood*; D015415:Biomarkers / Q000097:blood*; D053379:Chromogranin A / Q000097:blood*; D019861:Enterochromaffin-like Cells / Q000473:pathology; D005260:Female; D005755:Gastrins / Q000097:blood*; D006801:Humans; D006965:Hyperplasia / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010295:Parietal Cells, Gastric / Q000276:immunology*
D015415:Biomarkers; D053379:Chromogranin A; D005755:Gastrins