Short report
Spuriously elevated plasma calcitonin in a patient with a thyroid
nodule not associated with medullary thyroid carcinoma
E J Lamba, R M Heddleb, A Ellisc
a Kent and
Canterbury Hospitals NHS Trust, Canterbury, CT1 3NG, UK
Department of Clinical Biochemistry, b Department of Surgery, c UKNEQAS
for Peptide Hormones, Department of Clinical Biochemistry, The Royal
Infirmary of Edinburgh, Edinburgh EH3 9YW, UK
Correspondence to: Dr Edmund Lamb, Department of Clinical Biochemistry, Kent and Canterbury Hospitals NHS Trust, Ethelbert Road, Canterbury, Kent CT1 3NG, UK
Accepted 16 November
1998
An increase in plasma calcitonin concentration is widely
regarded as a specific and sensitive indication of underlying medullary thyroid carcinoma (MTC). We present a case in which the association of
increased plasma calcitonin concentration and a thyroid nodule was not
due to MTC. Subsequent measurement of plasma calcitonin by a variety of
methods highlighted the variability that exists in calcitonin
measurement and the potential for clinically misleading results. The
rationale for investigation and treatment of MTC, including a
recommendation to screen all patients with thyroid nodules using plasma
calcitonin measurement, is based on the use of specific two-site
calcitonin assays which are not universally used in the UK or USA.
Keywords: calcitonin; thyroid carcinoma; radioimmunoassay; immunometric assay
© 1999 by The Fellowship of Postgraduate Medicine
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