VIPoma laboratory findings: Difference between revisions
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==Overview== | ==Overview== | ||
Laboratory tests used in the diagnosis of VIPoma include serum vasoactive intestinal polypeptide (VIP) levels, basal gastric acid output, potassium, bicarbonate, magnesium, and calcium levels. | Laboratory tests used in the diagnosis of VIPoma include serum vasoactive intestinal polypeptide (VIP) levels, basal gastric acid output, potassium, bicarbonate, magnesium, and calcium levels. | ||
==Laboratory Findings== | ==Laboratory Findings== | ||
Laboratory findings consistent with the diagnosis of VIPoma include: | Laboratory findings consistent with the diagnosis of VIPoma include: | ||
*Elevated serum vasoactive intestinal polypeptide (VIP) levels: Normal fasting serum VIP level is generally < 75pg/ml whereas VIPomas have levels generally > 500pg/ml.<ref name="pmid23582916">{{cite journal| author=Ito T, Igarashi H, Jensen RT| title=Pancreatic neuroendocrine tumors: clinical features, diagnosis and medical treatment: advances. | journal=Best Pract Res Clin Gastroenterol | year= 2012 | volume= 26 | issue= 6 | pages= 737-53 | pmid=23582916 | doi=10.1016/j.bpg.2012.12.003 | pmc=3627221 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23582916 }}</ref> VIP level > 200pg/ml is strongly suggestive of VIPoma. Hormone measurement taken at the time of diarrhea episode has the highest yield as VIP secretion is during period of diarrhea and has short t1/2 (approx. 2 mins in blood). Single measurement should be confirmed by repeat testing. | *Elevated serum vasoactive intestinal polypeptide (VIP) levels: Normal fasting serum VIP level is generally < 75pg/ml whereas VIPomas have levels generally > 500pg/ml.<ref name="pmid23582916">{{cite journal| author=Ito T, Igarashi H, Jensen RT| title=Pancreatic neuroendocrine tumors: clinical features, diagnosis and medical treatment: advances. | journal=Best Pract Res Clin Gastroenterol | year= 2012 | volume= 26 | issue= 6 | pages= 737-53 | pmid=23582916 | doi=10.1016/j.bpg.2012.12.003 | pmc=3627221 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23582916 }}</ref> VIP level > 200pg/ml is strongly suggestive of VIPoma. Hormone measurement taken at the time of diarrhea episode has the highest yield as VIP secretion is during period of diarrhea and has short t1/2 (approx. 2 mins in blood). Single measurement should be confirmed by repeat testing. | ||
*Elevated pancreatic polypeptide levels (Normal < 312pg/ml) and neurotensin levels. | *Elevated pancreatic polypeptide levels (Normal < 312pg/ml)<ref name="pmid27583474">{{cite journal| author=Nilubol N, Freedman EM, Quezado MM, Patel D, Kebebew E| title=Pancreatic Neuroendocrine Tumor Secreting Vasoactive Intestinal Peptide and Dopamine With Pulmonary Emboli: A Case Report. | journal=J Clin Endocrinol Metab | year= 2016 | volume= 101 | issue= 10 | pages= 3564-3567 | pmid=27583474 | doi=10.1210/jc.2016-2051 | pmc=5052354 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27583474 }}</ref> and neurotensin levels. | ||
*Low serum [[potassium]], [[bicarbonate]], and [[magnesium]] levels secondary to fecal loss. | *Low serum [[potassium]], [[bicarbonate]], and [[magnesium]] levels secondary to fecal loss. | ||
*High calcium levels secondary to fecal loss. | *High calcium levels secondary to fecal loss. | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Madhu Sigdel M.B.B.S.[2]Parminder Dhingra, M.D. [3]
Overview
Laboratory tests used in the diagnosis of VIPoma include serum vasoactive intestinal polypeptide (VIP) levels, basal gastric acid output, potassium, bicarbonate, magnesium, and calcium levels.
Laboratory Findings
Laboratory findings consistent with the diagnosis of VIPoma include:
- Elevated serum vasoactive intestinal polypeptide (VIP) levels: Normal fasting serum VIP level is generally < 75pg/ml whereas VIPomas have levels generally > 500pg/ml.[1] VIP level > 200pg/ml is strongly suggestive of VIPoma. Hormone measurement taken at the time of diarrhea episode has the highest yield as VIP secretion is during period of diarrhea and has short t1/2 (approx. 2 mins in blood). Single measurement should be confirmed by repeat testing.
- Elevated pancreatic polypeptide levels (Normal < 312pg/ml)[2] and neurotensin levels.
- Low serum potassium, bicarbonate, and magnesium levels secondary to fecal loss.
- High calcium levels secondary to fecal loss.
- Low basal gastric acid output.
References
- ↑ Ito T, Igarashi H, Jensen RT (2012). "Pancreatic neuroendocrine tumors: clinical features, diagnosis and medical treatment: advances". Best Pract Res Clin Gastroenterol. 26 (6): 737–53. doi:10.1016/j.bpg.2012.12.003. PMC 3627221. PMID 23582916.
- ↑ Nilubol N, Freedman EM, Quezado MM, Patel D, Kebebew E (2016). "Pancreatic Neuroendocrine Tumor Secreting Vasoactive Intestinal Peptide and Dopamine With Pulmonary Emboli: A Case Report". J Clin Endocrinol Metab. 101 (10): 3564–3567. doi:10.1210/jc.2016-2051. PMC 5052354. PMID 27583474.