Skip to main content
NCBI home page
Canadian Medical Association Journal logoLink to Canadian Medical Association Journal
. 1978 Jul 8;119(1):29–35.

Calcium infusion and pentagastrin injection in diagnosis of medullary thyroid carcinoma.

M Verdy, J P Cholette, J Cantin, A Lacroix, W C Sturtridge
PMCID: PMC1818282  PMID: 679097

Abstract

Calcium infusion and pentagastrin injection were compared as tests to stimulate calcitonin secretion for the detection of medullary carcinoma of the thyroid. Plasma concentrations of immunoreactive calcitonin were measured by radioimmunoassay before and during both stimulation tests in 2 persons who had been found at operation to have medullary thyroid carcinoma, 1 relative in whom a cervical lymph node biopsy had shown medullary thyroid carcinoma and 36 asymptomatic relatives. The tests were carried out on separate days by intravenous infusion of calcium gluconate for 2 hours, to provide 3.75 mg/kg of elemental calcium per hour, and rapid intravenous injection of 0.5 microgram/kg of pentagastrin. Before stimulation immunoreactive calcitonin was undetectable in the plasma of 34 of the 36 asymptomatic persons; the 2 with elevated baseline concentrations of the hormone had a positive response to both tests. Seven others showed an increase in plasma immunoreactive calcitonin concentration only after pentagastrin injection. The two persons with initially elevated values and three of the seven with increased values after pentagastrin injection were found at subsequent operation to have focal medullary carcinoma and parafollicular cell hyperplasia; after the operation immunoreactive calcitonin was undetectable in the plasma, even after stimulation. Rapid injection of pentagastrin is more reliable than slow infusion of calcium as a stimulation test for the early detection of medullary thyroid carcinoma.

Full text

PDF
29

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Deftos L. J., Bury A. E., Habener J. F., Singer F. R., Potts J. T., Jr Immunoassay for human calcitonin. II. Clinical studies. Metabolism. 1971 Dec;20(12):1129–1137. doi: 10.1016/0026-0495(71)90038-2. [DOI] [PubMed] [Google Scholar]
  2. Deftos L. J. Immunoassay for human calcitonin. I. Method. Metabolism. 1971 Dec;20(12):1122–1128. doi: 10.1016/0026-0495(71)90037-0. [DOI] [PubMed] [Google Scholar]
  3. Deftos L. J. Radioimmunoassay for calcitonin in medullary thyroid carcinoma. JAMA. 1974 Jan 28;227(4):403–406. [PubMed] [Google Scholar]
  4. HAZARD J. B., HAWK W. A., CRILE G., Jr Medullary (solid) carcinoma of the thyroid; a clinicopathologic entity. J Clin Endocrinol Metab. 1959 Jan;19(1):152–161. doi: 10.1210/jcem-19-1-152. [DOI] [PubMed] [Google Scholar]
  5. HUNTER W. M., GREENWOOD F. C. Preparation of iodine-131 labelled human growth hormone of high specific activity. Nature. 1962 May 5;194:495–496. doi: 10.1038/194495a0. [DOI] [PubMed] [Google Scholar]
  6. Heath H., 3rd, Sizemore G. W., Carney J. A. Preoperative diagnosis of occult parathyroid hyperplasia by calcium infusion in patients with multiple endocrine neoplasia, type 2a. J Clin Endocrinol Metab. 1976 Aug;43(2):428–435. doi: 10.1210/jcem-43-2-428. [DOI] [PubMed] [Google Scholar]
  7. Herbert V., Lau K. S., Gottlieb C. W., Bleicher S. J. Coated charcoal immunoassay of insulin. J Clin Endocrinol Metab. 1965 Oct;25(10):1375–1384. doi: 10.1210/jcem-25-10-1375. [DOI] [PubMed] [Google Scholar]
  8. Melvin K. E., Miller H. H., Tashjian A. H., Jr Early diagnosis of medullary carcinoma of the thyroid gland by means of calcitonin assay. N Engl J Med. 1971 Nov;285(20):1115–1120. doi: 10.1056/NEJM197111112852004. [DOI] [PubMed] [Google Scholar]
  9. Parthemore J. G., Bronzert D., Roberts G., Deftos L. J. A short calcium infusion in the diagnosis of medullary thyroid carcinoma. J Clin Endocrinol Metab. 1974 Jul;39(1):108–111. doi: 10.1210/jcem-39-1-108. [DOI] [PubMed] [Google Scholar]
  10. Rosselin G., Assan R., Yalow R. S., Berson S. A. Separation of antibody-bound and unbound peptide hormones labelled with iodine-131 by talcum powder and precipitated silica. Nature. 1966 Oct 22;212(5060):355–357. doi: 10.1038/212355a0. [DOI] [PubMed] [Google Scholar]
  11. Rude R. K., Singer F. R. Comparison of serum calcitonin levels after a 1-minute calcium injection and after pentagastrin injection in the diagnosis of medullary thyroid carcinoma. J Clin Endocrinol Metab. 1977 May;44(5):980–983. doi: 10.1210/jcem-44-5-980. [DOI] [PubMed] [Google Scholar]
  12. Schimke R. N., Hartmann W. H. Familial amyloid-producing medullary thyroid carcinoma and pheochromocytoma. A distinct genetic entity. Ann Intern Med. 1965 Dec;63(6):1027–1039. doi: 10.7326/0003-4819-63-6-1027. [DOI] [PubMed] [Google Scholar]
  13. Williams E. D., Brown C. L., Doniach I. Pathological and clinical findings in a series of 67 cases of medullary carcinoma of the thyroid. J Clin Pathol. 1966 Mar;19(2):103–113. doi: 10.1136/jcp.19.2.103. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Williams E. D. Histogenesis of medullary carcinoma of the thyroid. J Clin Pathol. 1966 Mar;19(2):114–118. doi: 10.1136/jcp.19.2.114. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Wolfe H. J., Melvin K. E., Cervi-Skinner S. J., Saadi A. A., Juliar J. F., Jackson C. E., Tashjian A. H., Jr C-cell hyperplasia preceding medullary thyroid carcinoma. N Engl J Med. 1973 Aug 30;289(9):437–441. doi: 10.1056/NEJM197308302890901. [DOI] [PubMed] [Google Scholar]

Articles from Canadian Medical Association Journal are provided here courtesy of Canadian Medical Association

RESOURCES