What marker is seen in Carcinoid (CREST) syndrome, specifically in relation to calcitonin levels and other associated markers like Carcinoembryonic Antigen (CEA)?

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Markers in CREST Syndrome

The primary marker seen in CREST syndrome is anticentromere antibody, which is present in 98% of patients with this condition. 1

Primary Serologic Marker

  • Anticentromere antibody is the hallmark serologic marker of CREST syndrome, producing a discrete speckled pattern of immunofluorescence on HEp-2 cells and reacting specifically with the centromeric region of metaphase chromosomes. 1

  • This antibody is found in high titers (>1:80) in 26 of 27 patients (98%) with CREST syndrome, making it highly sensitive and relatively specific for this condition. 1

Specificity Considerations

  • While highly associated with CREST syndrome, anticentromere antibodies can occasionally be found in other conditions, though at much lower frequencies:

    • 3 of 14 patients (21%) with Raynaud's disease 1
    • 3 of 26 patients (12%) with diffuse systemic sclerosis 1
    • 1 of 60 patients (2%) with systemic lupus erythematosus 1
    • 1 of 15 patients (7%) with mixed connective tissue disease 1
  • The antibody is not detected in rheumatoid arthritis, Sjögren's syndrome, linear scleroderma, or age-matched controls with osteoarthritis. 1

Clinical Significance

  • Anticentromere antibodies can appear early in the disease course, sometimes when only Raynaud's phenomenon is present and before the full CREST syndrome (Calcinosis, Raynaud's phenomenon, Esophageal dysmotility, Sclerodactyly, Telangiectasia) becomes clinically apparent. 1

  • Other autoantibodies commonly found in connective tissue diseases (anti-DNA, anti-RNP, anti-SS-B) are not found in CREST syndrome patients, further distinguishing this as a unique serologic entity. 1


Note: The question appears to reference "CRET syndrome," but based on the clinical context and available evidence, this refers to CREST syndrome (also known as limited cutaneous systemic sclerosis), not carcinoid syndrome or medullary thyroid carcinoma, which are associated with calcitonin and CEA markers discussed in the other provided evidence.

References

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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