Overnight fasting before blood collection is required
Serum and Fluoride are unacceptable.
Pancreatic polypeptide (PP) secreting tumour (PPoma) is rare. Other than causing local mechanical effect, it is usually clinically silent and considered non-functional. On the other hand, 75% of all pancreatic endocrine tumours have raised circulating PP. However, the diagnostic accuracy of raised PP for endocrine secreting tumour is not great, even though some tumours may show exaggerated PP response to secretin stimulation. Raised PP can also be observed in 29-50% of carcinoid syndromes. PP is not raised in adenocarcinoma of pancreas.
Not every patient with raised PP levels has a tumour. Raised PP also occurs as part of the MEN-1 syndrome and may reflect nesidioblastosis of PP cells or multiple adenomata. PP is also raised in chronic renal failure.
In chronic pancreatitis, a subnormal rise in PP after intravenous secretin stimulation (peak over basal ratio of <5) has been suggested as a non-invasive method to distinguish normal/minimal from moderate/advanced chronic pancreatitis.
As PP's release can be enhanced by vagal cholinergic stimulation and abolishes by atropine pre-treatment, it can be used post sham feeding to assess vagal nerve function.
References:
Vinik AI Pancreatic Polypeptide PPoma August 2004. Chapter 9 at http://www.endotext.org/guthormones/guthormone9/guthormoneframe9.htm, last accessed 21/4/09
Stern I, Robert-Thompson IC, Hansky J. Correlation between pancreatic polypeptide response to secretin and ERCP findings in chronic pancreatitis. Gut 1982; 23(3): 235?8
Emails to chemicalpathologist@adhb.govt.nz will receive priority attention from the on-call chemical pathologist.
If the query concerns a specific patient please include the NHI number in your email.
If email is not a suitable option, please contact the on-call chemical pathologist via Lablink (Auckland City Hospital ext. 22000 or 09-3078995).
Individual chemical pathologists may be contacted but will not be available at all times.
After-hours : contact Lablink (Auckland City Hospital ext. 22000 or 09-3078995) or hospital operator for on duty staff after hours.
Dr Samarina Musaad (Clinical Lead) : SamarinaM@adhb.govt.nz ext. 22402
Dr Cam Kyle: CampbellK@adhb.govt.nz ext 22052
Dr Weldon Chiu: WeldonC@adhb.govt.nz ext. 23427
Dr Campbell Heron: CHeron@adhb.govt.nz ext. 23427
Dr Sakunthala Jayasinghe: Sakunthala@adhb.govt.nz ext. 23427
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Patient preparation/Sample collection |
The patient must have been fasting overnight 5mL EDTA |
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Sample preparation |
Centrifuge and separate EDTA plasma Minimum 0.5mL required. Preferred >1mL |
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Transport to LabPlus |
Send either ambient or at 4 o C |