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test name results units bio. ref. interval chromogranin a; cga, plasma (trace) 123.60 ng/ml <76.30 note 1. this test is not recommended for diagnostic purposes 2. cga values may rise during treatment with proton pump inhibitors (ppi). it is recommended to stop ppi treatment for at least two weeks before determination of cga comments chromogranin a is a major soluble protein present in chromaffin cells of adrenal medulla, sympathetic neurons and various neuroendocrine organs. about 80% patients of pheochromocytoma show elevated levels of chromogranin a. the major use of this test is in the post operative monitoring for recurrence of these tumors. it is a preferred marker in hind gut carcinoid tumors which commonly are non -functional and have lost the ability to secrete serotonin, but retain the ability to secrete cga. increased levels · malignant causes - carcinoid tumor, pheochromocytoma, medullary carcinoma thyroid, small cell lung carcinoma & epithelial cancers with neuroendocrine differentiation · non malignant causes - renal impairment (creatinine clearance <80mg/ml/min), liver disease, inflammatory bowel disease, atrophic gastritis & stress
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