Increased serum and urinary calcitonin levels in patients with pulmonary disease

Serum and urinary calcitonin levels were measured in patients with acute and chronic inflammatory diseases of the lung. Using both carboxyl terminal and midportion antisera, the incidence of increased immunoreactive values of this hormone was 68 percent for patients with emphysema, 59 percent for tuberculosis, and 89 percent for acute bacterial pneumonitis. In order to determine the source of the high levels of calcitonin, immunoperoxidase stains were made of sections of human lung; the hormone was found within the bronchial Kultschitzky cell (K cell). This suggests a specific endocrine role for the K cell, and may explain not only the high calcitonin levels in patients with inflammatory lung disease, but also the high levels associated with both carcinoid tumor and small cell carcinoma, which may originate from K cells. It is apparent that moderately high levels of calcitonin in a patient with pulmonary disease cannot always be associated with tumor.