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lüll The role of serum chromogranin A in diarrhoea predominant irritable bowel syndrome Sidhu R; McAlindon ME; Leeds JS; Skilling J; Sanders DSJ Gastrointestin Liver Dis 2009[Mar]; 18 (1): 23-6BACKGROUND & AIMS: Elevated serum chromogranin A (CgA) levels have been reported co-incidentally in a small group of irritable bowel syndrome (IBS) patients (n=19). Our aim was to ascertain the prevalence of elevated CgA in diarrhoea predominant Rome II IBS (D-IBS) patients and investigate if this could be a marker for octreotide therapy. METHODS: Patients with Rome II D-IBS were recruited prospectively and investigated as per British Society Guidelines including serial CgA levels (u/l). Patients with refractory symptoms and elevated CgA were considered for further investigation + or - octreotide therapy. RESULTS: 219 patients were recruited (68% females, mean age 45 years). 81% (n=177) of IBS patients had normal CgA levels (0-20u/l). Whilst 12.3% (n=27) had values between 20-60u/l, 6.8% (n=15) had CgA levels >60u/l; 96% (26/27) with initial CgA level of 20-60u/l had repeated CgA levels which normalised. One patient (3.7%) had a gastric adenocarcinoma. In the 15 patients with elevated CgA levels >60u/l, 8 normalised on repeated testing. In the other 7, there were no cases of carcinoid, n=1 gastric leiomyoma, n=1 rectal tumour and 4 patients had persistently elevated CgA levels but with improvement of symptoms. In one patient, octreotide was commenced which resulted in normalisation of CgA and symptoms. CONCLUSION: CgA levels appear to be transiently elevated in D-IBS. Future work assessing CgA in patients with refractory D-IBS may potentially identify individuals who will benefit from octreotide therapy.|Biomarkers/blood[MESH]|Chromogranin A/*blood[MESH]|Diarrhea/*blood/drug therapy/etiology[MESH]|Female[MESH]|Gastrointestinal Agents/therapeutic use[MESH]|Humans[MESH]|Irritable Bowel Syndrome/*blood/complications/drug therapy[MESH]|Male[MESH]|Middle Aged[MESH]|Octreotide/therapeutic use[MESH]|Patient Selection[MESH]|Predictive Value of Tests[MESH]|Prospective Studies[MESH]|Severity of Illness Index[MESH]|Time Factors[MESH]|Treatment Outcome[MESH]|Up-Regulation[MESH] |