Perhaps NEQAS could have a role here?
Ian Barlow
Scunthorpe
> -----Original Message-----
> From: Bernie Croal [SMTP:[log in to unmask]]
> Sent: Thursday, July 11, 2002 7:01 PM
> To: [log in to unmask]
> Subject: Re: TAMOXIFEN
>
> 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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