Zusammenfassung
Die Bestimmung des Chromogranin-A-Spiegels (CgA-Spiegel) im Blut kann für das Monitoring
von neuroendokrinen Tumoren verwendet werden. CgA kann aber auch bei verschiedenen
anderen endokrinen und nicht endokrinen Erkrankungen erhöht sein. Wir berichten über
einen Patienten mit einem zufällig entdeckten Tumor der linken Nebenniere und einem
erhöhten CgA-Spiegel. Die Adrenalektomie bestätigte nicht die vermutete Diagnose eines
Phäochromozytoms. Postoperativ fiel ein weiterhin erhöhter CgA-Spiegel auf, der die
Vermutung eines weiteren neuroendokrinen Tumors nahe legte, welche trotz einer umfangreichen
Diagnostik nicht bestätigt werden konnte. Schließlich wurde entdeckt, dass eine kontinuierliche
Protonenpumpenhemmereinnahme wegen einer Refluxösophagitis einen falsch erhöhten CgA-Spiegel
verursacht hatte.
Abstract
Measurement of chromogranin A (CgA) level in blood can be used to monitor neuroendocrine
tumours. However CgA level may also be elevated in several other endocrine and non-endocrine
diseases. Here, we report on a patient with an incidental left-sided adrenal tumour
and elevated CgA level. Adrenalectomy did not confirm clinically suspected diagnosis
of pheochromocytoma. Postoperative follow-up was remarkable for a persistently elevated
CgA level suspecting another neuroendocrine tumour which could not be detected despite
extensive investigations. Finally, it was discovered that continuous proton-pump inhibitor
administration for gastro-oesophageal reflux disease had caused a falsely elevated
CgA level.
Schlüsselwörter
Protonenpumpenhemmer - Chromogranin A - neuroendokriner Tumor
Key words
proton-pump inhibitor - chromogranin A - adrenal incidentaloma
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PD Dr. Marcus Wolf Wiedmann
Abteilung Innere I, St.-Marien-Krankenhaus Berlin
Gallwitzallee 123 – 143
12249 Berlin
Germany
Phone: ++ 49/30/76 78 32 50
Fax: ++ 49/30/76 78 34 25
Email: wiedmann@marienkrankenhaus-berlin.de
