Endocrine Abstracts

The pentagastrin-stimulated calcitonin test is known and widely used in monitoring patients with MTC. Given the problems of pentagastrin availability other diagnostic tests are being tried.

The goal of the study was the evaluation of safety and tolerance of high-dose calcium to stimulate calcitonin in MTC patients.

Materials: The study included 41 patients after surgery for medullary thyroid cancer who were under observation. Patients underwent calcitonin stimulation using high-dose calcium while observing tolerance and undesired side effects. Six months earlier the same patients underwent calcitonin stimulation using pentagastrin. Patients compared the tolerability of the two tests.

Results: Undesired side effects occurred in 37 (90%) of 41 patients. The most frequently reported side effects by patients were: feeling heat 35/37, metallic taste 10/37, flushing of face 8/37, sweating 5/37, nausea 5/37, facial paresthesia 4/37, dizziness 1/37, and weakness 1/37. Symptoms occurs in the first or second minute of administering of calcium. Symptoms resolved after 1 to 5 min until the completion of injection. Patients assessment comparing tests using pentagastrin and calcium rated the calcium test: more tolerable 30/41, equally tolerated 10/41, worse tolerated 1/41.

Conclusions: The calcitonin stimulation test using high-dose calcium is safe and well tolerated. Although side effects occurred frequently (90% of patients), most were mild and transient.