case_images: PMC3420657_01
case_images: Marked escalation of serum chromogranin A levels 4 months after initial sampling on proton pump inhibitor rapid normalisation after 3 weeks of its withdrawal.
case_images: CRIM.ENDOCRINOLOGY2011-342480.001.jpg
case_images: PMC3420657_01_CRIM.ENDOCRINOLOGY2011-342480.001.jpg
case_images: fig1
case_images: An initial serum CgA measured by enzyme-linked immunosorbent assay (0.5 U/L detection limit; Dako, Denmark) was noted to be moderately elevated 46.0 U/L (normal < 17.2 U/L) and rose to 176 U/L in 4 months (Figures 1 and 2).
case_images: CT scan of the abdomen showing a 3.6 x 2.4 cm cystic lesion within the uncinate process of the pancreas extending into the pancreatic head.
case_images: CRIM.ENDOCRINOLOGY2011-342480.002.jpg
case_images: PMC3420657_01_CRIM.ENDOCRINOLOGY2011-342480.002.jpg
case_images: fig2
case_images: An initial serum CgA measured by enzyme-linked immunosorbent assay (0.5 U/L detection limit; Dako, Denmark) was noted to be moderately elevated 46.0 U/L (normal < 17.2 U/L) and rose to 176 U/L in 4 months (Figures 1 and 2). This medication was then subsequently suspended resulting in normalization of CgA (Figure 2) and subsequent 6-month followup confirmed consistently undetectable serum CgA levels while off the PPI. 131I-MIBG scintigraphy did not show pathologic isotope accumulation and serial CT scan of abdomen revealed no increase in size of the pancreatic mass.