Abstract library

87 results for "proton pump inhibitors".
#53 The rise and fall of chromogranin A as an indicator for NET
Introduction: There is now general awareness that treatment with proton pump inhibitors (ppi) may cause moderate rises in circulating concentrations of gastrin and/or chromogranin A (CgA), thus decreasing the specificity of these markers in the diagnosis of neuroendocrine tumors (NETs). Due to their high efficacy, proton pump inhibitors (ppi) are one of the most frequently prescribed classes of drugs worldwide. Several studies in various countries report that 30% or more of in-patients have been prescribed ppi. Patients who are suspected of having a neuroendocrine tumor (NET) often have gastrointestinal (GI) symptoms for which ppi are prescribed and therefore they may be already taking ppi when their first blood sample is assayed for NET markers. We previously encountered a case of extreme rise in CgA which flagged the possibility of a NET, but was later shown to be due to ppi therapy alone. We present CgA and gastrin data in relation to ppi therapy and withdrawal for this patient. In order to see if this was an isolated incident, we audited all laboratory requests for CgA/gastrin in a two-year period and monitored those that provided details of ppi treatment/withdrawal.
Conference: 7th Annual ENETS Conference (2010)
Category: Clinical
Presenting Author: Dr Lee Armstrong
#1069 Gastric Neuroendocrine Neoplasms and Long-Term Proton Pump Inhibitors: Need for a Revision of Classifications?
Introduction: Gastric neuroendocrine neoplasm (gNENs) include three types: type 1 and 2 related to hypergastrinemia due to chronic atrophic gastritis(CAG) or Zollinger-Ellison syndrome (ZES) respectively, and type 3 normogastrinemic and more aggressive. Few cases of gNENs in patients taking proton pump inhibitors (PPI) have been reported
Conference: 12th Annual ENETS Conference (2015)
Category: Clinical cases/reports
Presenting Author: MD Federica Cavalcoli
Keywords: PPI, gNEN, classification, CAG
#386 A Prospective Evaluation of the Effects of Chronic Proton Pump Inhibitor Use on Plasma Biomarker Levels in Humans
Introduction: Proton pump inhibitors (PPIs) are used primarily to treat gastroesophageal reflux disease. PPI-induced achlorhydria increases circulating gastrin and chromogranin A (CGA). CGA is a widely used biomarker for the diagnosis and follow-up for gut-based neuroendocrine tumors (NETs). PPI-induced increases in CGA or gastrin may falsely suggest the presence of a NET when none exists. Pancreastatin, a fragment of CGA, is also commonly used to diagnose and follow NETs.
Conference: 9th Annual ENETS Conference (2012)
Category: Clinical
Presenting Author: Dr Eugene Woltering
#17 Diagnostic efficacy of the secretin stimulation test for the Zollinger-Ellison syndrome: an intra-individual comparison using different dosages in patients and controls
Introduction: The diagnosis of Zollinger-Ellison syndrome is suspected in patients with symptoms of gastric acid hypersecretion, i.e., peptic ulcer disease, malabsorption or diarrhea, or with elevated fasting serum gastrin levels. However, symptoms can be masked by the use of proton pump inhibitors and fasting serum gastrin values are not always conclusive. Therefore, the secretin stimulation test is advocated as the principal diagnostic tool to identify the Zollinger-Ellison syndrome.
Conference: 7th Annual ENETS Conference (2010)
Category: Clinical
Presenting Author: Patricia Kuiper
#18 Long-acting release octreotide induce complete response in type 1 gastric carcinoid tumors
Introduction: Gastric endocrine tumors (GET) are increasingly recognized due to expanding indications of upper gastrointestinal endoscopy. Often silent and benign, GET may also be aggressive when sporadic and may sometimes mimic the course of gastric adenocarcinoma. Current incidence of GETs is estimated at around 8% of digestive endocrine tumors. Yearly age-adjusted incidence is around 0.2 per population of 100,000. Gastric carcinoids (ECLomas) develop from gastric enterochromaffin-like cells (ECL cells) in response to chronically elevated gastrin. Type 1 tumors (ECLomas in the course of atrophic gastritis) may occur in conditions of achlorhydria secondary to auto-immune atrophic fundic gastritis. It occurs mostly in women and they are non-functioning tumors, typically found during upper GI endoscopy performed for dyspepsia. ECLomas present frequently as multiple polyps, usually < 1 cm in diameter in the gastric fundus. Type 1 tumors are almost exclusively benign lesions with little risk of deep invasion of the gastric parietal wall. The neoplastic ECL cells become progressively dedifferentiated with an increasing number of Ki-67 immunoreactive (IR) cell nuclei. In addition, there is a substantial decrease in argynophil and IR NE cells that can be visualized by conventional methods. ECLomas secondary to hypergastrinemia should be closely followed for signs of clinical and histopathological tumor progression. Such ECLomas deserve early, active, radical surgical treatment.
Traditionally, gastric carcinoid type 1 (GCA1s) are endoscopically or surgically removed, depending on the number, appearance and size of the tumors. Antrectomy, with surgical excision of the majority of the G cells, is thought to facilitate regression of these tumors by removing the source of excessive gastrin secretion; however, the long-term benefits of antrectomy still remain uncertain. Although proton pump inhibitors are effective in reducing hypergastrinemia-induced gastric acid hypersecretion in GCA2, they do not affect ECL-cell hyperplasia, and therefore their role in GCA1 is limited. Moreover, in selected cases, significant reduction of hypergastrinemia does not prevent development of ECL carcinoid, suggesting that, in addition to hypergastrinemia, other pathogenic or genetic factors may be involved. Treatment with somatostatin analogues (SSA) might impede ECL-cell hyperplasia by suppressing gastrin secretion and/or by a direct anti-proliferative effect on ECL cells. Treatment with SSAs in GCA1 leads to a substantial tumor load reduction, with a concomitant decrease of serum gastrin levels. Published data indicate an important anti-proliferative effect of SSA on ECL cells, providing clinical benefit and obviating, at least temporarily, the need for invasive therapies for GCA1. Morphometric studies demonstrated that, while antrectomy specifically decreased the volume of ECL cells versus the total volume of endocrine cells, octreotide reduces the overall endocrine cell volume. Although the number of treated patients is small, it has been suggested that SSA may exert important anti-proliferative effects either directly, by inhibiting ECL-cells proliferation, or indirectly through suppression of gastrin hypersecretion.
Conference: 7th Annual ENETS Conference (2010)
Category: Clinical
Presenting Author: MD Ricardo Caponero
#83 Surgical treatment of duodenopancreatic neuroendocrine tumors (pNETs) in patients with multiple endocrine neoplasia type 1 (MEN 1): a Dutch consensus statement
Introduction: Duodenopancreatic neuroendocrine tumors (pNETs) in multiple endocrine neoplasia type 1 (MEN 1) are the most important cause of MEN 1-related death. Surgery is the only curative treatment, but controversy exists on the optimal strategy. Recent guidelines on pNETs have limited recommendations specific for MEN 1. Therefore, a Dutch multidisciplinary consensus meeting was organized.
Conference: 7th Annual ENETS Conference (2010)
Category: Clinical
Presenting Author: MD Carolina RC Pieterman
#1740 A Nomogram Consisted of Routine Biochemical Tests May Increase the Diagnostic Accuracy of Chromogranin A in Detecting Patients with Neuroendocrine Tumors
Introduction: Serum chromogranin A (CgA) may be falsley increased in patients with renal impairment and systemic inflammation.
Conference: 14th Annual ENETS conference (2017)
Category: Biomarkers
Presenting Author: MD, PhD Ivan Kruljac
#1756 Somatostatin Analogs in Patients with Multiple Endocrine Neoplasia Type 1 and Zollinger-Ellison Syndrome: Efficacy and Safety
Introduction: Zollinger-Ellison syndrome (ZES) can cause severe complications. In multiple endocrine neoplasia type 1 (MEN1) related ZES, surgery has a controversial role and proton pump inhibitors (PPI) are usually first-line therapy, although some concerns regarding long-term use. Somatostatin analogs (SSA) both reduce hypergastrinemia and have an antiproliferative role.
Conference: 14th Annual ENETS conference (2017)
Category: Medical treatment - SMS analogues, interferon
Presenting Author: MD Roberta Modica
#1917 Clinical Correlates of Discrepant Results of Chromogranin a versus Serotonin Markers in Patients with Neuroendocrine Tumors
Introduction: Neuroendocrine tumors lead to elevated chromogranin A levels and elevated serotonin markers (urinary 5HIAA and platelet serotonin). These markers are employed for diagnosis and monitoring.
Conference: 14th Annual ENETS conference (2017)
Category: Biomarkers
Presenting Author: Dr Wim Meijer
Authors: Meijer W, Bruikman C, Beukeveld G, ...
#815 The Effect of Autophagy Inhibitors Alone or in Combination with mTOR Inhibitors in a Neuroendocrine Tumor Cell Model
Introduction: Most patients with neuroendocrine tumors (NETs) require systemic treatment, often with a limited therapeutic effect. RAD001 and Torin1 are mTOR inhibitors (mTORi) known to suppress cell proliferation in NETs. However, cancer cells may use mTORi-induced autophagy to escape the anti-proliferative effect and to prolong cell survival. Chloroquine (CQ) and hydroxychloroquine (HCQ) inhibit autophagy.
Conference: 11th Annual ENETS Conference (2014)
Category: Basic Science - mTOR and other pathways, signalling, receptors
Presenting Author: Dr. Simona Glasberg