Pete,
Re your patient with High oestradiol on Tamoxifen.
I had noticed this in a number of patients some years ago and presented a
case at the IFCC meeting showing this link in a patient (Croal BL, Glen
ACA. Tamoxifen, supraphysiological oestradiol and gallstones. Proceedings
of the XVI International Congress of Clinical Chemistry, London 1996: 41-
2). At the end of the day I was not sure whether the oestradiol was real or
a cross reaction by the tamoxifen molecule with the assay - my main concern
is whether such prolonged supraphysiological oestradiol would be
detrimental despite apparent oestrogen receptor blockade - ie endometrial
ca and thrombus risk is elevated, and in our patient perhaps some sort of
effect on gallstone production (?excretion).
Always meant to follow it up, but never quite got there. Perhaps next step
would be to try different assays (I suspect there may be an element of
assay cross reactivity if the assay is direct to common amino acid
sequences on the oestradiol and Tamoxifen molecules. I wrote to several
manufacturers and the drug company at the time, but they were not really
interested !
Hope this is of help
regards
Bernie Croal
Clinical Senior Lecturer
Health Services Research & Clinical Biochemistry
Department of Clinical Biochemistry
Grampian University Hospitals Trust
Polwarth Building.
Aberdeen. UK.
AB25 2ZD.
Email: [log in to unmask]
Tel: +0044(0)1224554098
Fax: +0044(0)1224694378
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