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Related Experiment Videos

Plasma chromogranin-A in primary hyperparathyroidism.

M S Nanes1, D T O'Connor, S J Marx

  • 1Mineral Metabolism Section, National Institute of Diabetes and Digestive and Kidney Disease, Bethesda, Maryland 20892.

The Journal of Clinical Endocrinology and Metabolism
|November 1, 1989
PubMed
Summary

Elevated plasma chromogranin-A (Chr-A) in primary hyperparathyroidism is mainly seen in patients with Zollinger-Ellison syndrome (ZES). This suggests hyperparathyroidism may affect Chr-A levels through hypercalcemia or elevated parathyroid hormone (PTH).

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Area of Science:

  • Endocrinology
  • Oncologic Endocrinology
  • Clinical Biochemistry

Background:

  • Prior studies indicated elevated plasma chromogranin-A (Chr-A) in primary hyperparathyroidism.
  • The specific mechanisms and patient subgroups associated with this elevation were unclear.

Purpose of the Study:

  • To investigate the relationship between plasma chromogranin-A levels and different causes of primary hyperparathyroidism.
  • To explore potential correlations with other hormonal markers and clinical conditions like Zollinger-Ellison syndrome (ZES).

Main Methods:

  • Plasma Chr-A was measured in 55 controls and 73 patients with primary hyperparathyroidism (adenoma, hyperplasia, familial multiple endocrine neoplasia type 1 - FMEN1).
  • Samples were also analyzed for calcium, PTH, gastrin, and other hormones.

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  • Correlations and differences between patient groups and controls were statistically analyzed, including pre- and post-parathyroidectomy assessments.

    • Main Results:

    • Elevated plasma Chr-A was observed in FMEN1 and parathyroid hyperplasia compared to controls, but not uniformly across all primary hyperparathyroidism cases.
    • In FMEN1 patients, plasma Chr-A correlated with serum gastrin and plasma PTH.
    • Plasma Chr-A was significantly higher in FMEN1 patients with ZES compared to those without ZES. Parathyroidectomy did not lower Chr-A in most patients, except for a decrease in ZES patients post-surgery.

    Conclusions:

    • Elevated plasma Chr-A is not a universal feature of primary hyperparathyroidism but is primarily associated with patients who also have ZES.
    • Primary hyperparathyroidism might influence Chr-A levels via hypercalcemia or elevated PTH affecting pancreatic islet tissue secretion.
    • The findings highlight the importance of considering co-existing conditions like ZES when interpreting high Chr-A levels in hyperparathyroidism.