Imperial Collage Healthcare

Gut Hormones


Test Background

The only hormones measured by the Gut Hormone Laboratory are: Vasoactive intestinal peptide (VIP); pancreatic polypeptide (PP); gastrin; pancreatic glucagon (PG); somatostatin; cocaine- and amphetamine-regulated transcript (CART); chromogranin A (CgA); chromogranin B (CgB).


Clinical Indications
Suspected gastrinoma/somatostatinoma or Zollinger-Ellison syndrome: hypergastrinaemia, dyspepsia, diarrhoea, steatorrhoea, mixed endocrinopathy VIPoma: watery diarrhoea, hypokalaemia, achlorhydria, hypotension and flushing/vasodilation Glucagonoma: hyperglycaemia refractory to insulin, skin lesions, diarrhoea and stomatitis.


Reference Range

VIP normal <30pmol/L;
Glucagon normal < 50pmol/L;
Gastrin normal < 40pmol/L;
PP normal <300pmol/L;
Somatostatin normal < 150pmol/L;
CART normal < 130pmol/L;
CgA normal < 60pmol/L;
CgB normal <150pmol/L


Sample Required
Fasting sample (6-8 hours)


Sample Container
EDTA plasma


Sample Collection
Transfer blood to a commercial EDTA tube.  Mix by inversion and transfer without delay to the laboratory.  Centrifuge the blood within 15 minutes of venepuncture (this may be extended to 30 minutes if only CgA and CgB are required).


Sample Volume
6mL of blood to produce 3mL of plasma for full gut hormone profile. 2mL of blood to obtain 1mL of plasma for a single gut hormone request or CgA/CgB request.


Transport/Storage
Store plasma at -20oC or lower. Send plasma to Lab on dry ice by courier. Avoid sending over weekends and public holidays.


Turnaround Time
21 days from date of receipt excluding public holidays.


Notes
Visible haemolysis invalidates the result.  Delay in separation & freezing invalidates the result. For gastrin measurement, H2 blockers should be stopped for 72h and Omeprazole for two weeks, before blood is taken.


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