Abstract |
Objective: To describe an unusual case of symptomatic hyperchromograninemia associated with proton pump inhibitor (PPI) use. Case Summary: A 55-year-old man with stage 1 follicular lymphoma and GERD on omeprazole presented with symptoms suggesting carcinoid syndrome. The only positive finding on workup was a markedly elevated level of chromogranin A and no carcinoid tumor was identified. Omeprazole was discontinued, following which his symptoms resolved and chromogranin A levels returned to normal. To the best of our knowledge, no symptoms have been previously reported in association with PPI-induced hyperchromograninemia. Discussion: The reliability of chromogranin A as a marker for neuroendocrine tumors is of growing concern. The reasons for the associated symptomatology in this case are unclear but could involve physiologic effects of chromogranin A breakdown products. The role of pharmacogenomics in PPI metabolism is discussed as a potential explanation for the significant hyperchromograninemia. Conclusion: The phenomenon of PPI-induced hyperchromograninemia is highlighted for providers especially in the context of neuroendocrine tumor diagnosis and surveillance. The need for more research into chromogranins is proposed.
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Authors | Kwabena Oware Adu-Gyamfi, Richmond Gyamfi, Sandeep Patri |
Journal | Journal of community hospital internal medicine perspectives
(J Community Hosp Intern Med Perspect)
Vol. 9
Issue 6
Pg. 511-514
( 2019)
ISSN: 2000-9666 [Print] United States |
PMID | 32002161
(Publication Type: Case Reports)
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Copyright | © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group on behalf of Greater Baltimore Medical Center. |