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Lanreotide

Clinical Significance:
Lanreotide (Somatuline Depot®, Tercica) is used for the control of symptoms associated with functional neuroendocrine tumors. Frequent measurement of the lanreotide levels may be useful in guiding therapy in patients with poorly controlled symptoms or those patients experiencing tumor growth. Lanreotide levels in blood need to be in a specific range to be effective. Measuring lanreotide immediately prior to the monthly injection will determine trough levels of the drug in your blood.

Reference Range:
Mean lanreotide levels +/- 2SD for patients on Somatuline Depot® injections for 4 or more months (steady-state). The following values represent trough levels of lanreotide measured immediately before a patient's next injection of Somatuline Depot.
Lanreotide administered as Somatuline® Depot:
480 mg/month: 20,000 pg/mL ± 2,000 pg/mL
240 mg/month: 10,000 pg/mL ± 2,000 pg/mL
120 mg/month: 5,000 pg/mL ± 1,000 pg/mL
90 mg/month: 2,500 pg/mL ± 500 pg/mL

Procedure:
Lanreotide is measured by direct radioimmunoassay.

Patient Preparation:
This test is only useful for those patients being treated with Lanreotide. No special preparation is necessary since Lanreotide is not a naturally occurring substance. For optimal results, specimen should be collected immediately before the next injection of Lanreotide (trough levels) and after having been on the medication at least four months. Additional Lanreotide levels should be drawn in patients with evidence of tumor progression or loss of symptom control.

Specimen Collection:
Collect 3 mL serum or EDTA plasma and separate as soon as possible. Specimens collected for Lanreotide are stable at room temperature for 3 days. Specimens can be stored at room temperature, refrigerated, or frozen in dry ice. Minimum specimen size is 1 mL.

Shipping Instructions:
Specimens can be shipped at ambient temperature, refrigerated, or frozen in dry ice.

 

Leukotriene B4*
(LTB4)

* Test available on a research basis only. Contact ISI for details.

 

Leukotriene C4*
(LTC4)

* Test available on a research basis only. Contact ISI for details.

 

Leukotriene C4 + D4*
(LTC4 + D4)

* Test available on a research basis only. Contact ISI for details.

 

Leukotriene C4 + D4 + E4*
(LTC4 + D4 + E4)

* Test available on a research basis only. Contact ISI for details.

 

Luteinizing Hormone
(LH) *

* Test available on a research basis only. Contact ISI for details.

 

Luteinizing Hormone
(LH), urine*

* Test available on a research basis only. Contact ISI for details.

 

Luteinizing Hormone-Releasing Hormone
(LH-RH, Gonadotropin Releasing Hormone, Gn-RH)

Clinical Significance:
Luteinizing Hormone-Releasing Hormone (LH-RH), also known as Gonadotropin-Releasing Hormone (Gn-RH), is a decapeptide secreted pulsatily from the hypothalamus.  It stimulates the release of the Gonadotropins - Luteinizing Hormone and Follicle Stimulating Hormone - exerting a stronger effect on Luteinizing Hormone.  Testosterone and Estradiol, whose release is stimulated by the Gonadotropins, exert a negative feedback control on LH-RH both at the hypothalamic site and by decreasing pituitary receptor binding.  LH-RH levels are low in patients with hypothalamic hypogonadism differentiating them from the high levels usually found in primary hypopituitary hypogonadism.  Accentuation of the LH-RH pulse occurs at the onset of puberty triggering the release of LH and FSH required in pubertal development.  LH-RH is stimulated by Epinephrine and suppressed by Dopamine and opiates.  LH-RH and some of its agonists are frequently used to induce ovulation.

Reference Range:
Male:                                  4.0 -   8.0 pg/ml
Female:                               2.0 - 10.0 pg/ml

Procedure:
Luteinizing Hormone-Releasing Hormone is measured by direct radioimmuno-assay.

Patient Preparation:
Patient should not be on any Steroid, ACTH, Gonadotropin, or Estrogen medications, if possible, for at least 48 hours prior to collection of specimen.

Specimen Collection:
3 ml serum or EDTA plasma should be collected and separated as soon as possible.  Freeze specimen immediately after separation.  Minimum specimen size is 1 ml.

Special Specimens:
For tumor/tissue and various fluids (i.e. CSF, peritoneal, synovial, etc.) contact the Institute for requirements and special handling.

Shipping Instructions:
Ship specimens frozen in dry ice.

References:
J Schopohl, G Mehltretter, R von Zumbusch, T Eversmann, and L von Werder.  Comparison of Gonadotropin-Releasing Hormone and Gonadotropin Therapy in Male Patients with Idiopathic Hypogonadism.  Fertility and Sterility 56: 1143-1150, 1991.

2. CB Lambalk, J Schoemaker, GP van Rees, J de Koning, and HAMJ van Dieten.  Exogenous versus Endogenous Pulses of Luteinizing Hormone-Releasing Hormone and Secretory Patterns of Gonadotropins.  Fertility and Sterility 56: 446-452, 1991.

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