Calcitonin (CT) stimulation tests have great value and could help to: differentiate thyroid causes of elevated CT apart from non-thyroid sources, determine whether the patients with slightly elevated basal CT could/could not be candidates for surgery, and indicate the right moment for prophylactic thyroidectomy in children with MEN syndromes when with normal basal CT. This triggered the requests for development of CT stimulation tests, taking into consideration their safety and aimed us to write a systematic review of literature regarding the rationale, technical issues, and side effects of CT stimulating tests used for diagnosis of MTC. After a thorough review of the literature, we classified the reported side effects by severity, as defined by United States Food and Drug Administration. A statistical analysis was performed using IBM SPSS Statistics version 20. Various side effects were noticed during stimulation tests that differ by intensity, duration and severity, depending on types of substances and protocols used. The side effects after pentagastrin test were significantly more severe than those reported after calcium stimulation test (p=0.0396). There are also significant gender-specific differences in side effects induced by stimulation tests. In conclusion, we recommend performing Ca CT stimulation test when needed, considering preventive evaluation of some clinical, instrumental, and biochemical aspects of each patient. Precise instructions should be followed before a stimulation test and furthermore continuous cardiac monitoring is essential during and after the test to minimize the possibility of a serious event.

中文翻译：

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降钙素刺激试验：基本原理、技术问题和副作用：综述

降钙素 (CT) 刺激试验具有重要价值，可以帮助：区分 CT 升高的甲状腺原因与非甲状腺来源，确定基底 CT 轻度升高的患者是否适合/不适合手术，并指出正确的时机用于基础 CT 正常的 MEN 综合征患儿的预防性甲状腺切除术。这引发了开发 CT 刺激测试的要求，考虑到它们的安全性，并旨在我们撰写有关用于诊断 MTC 的 CT 刺激测试的基本原理、技术问题和副作用的文献的系统综述。在对文献进行彻底审查后，我们按照美国食品和药物管理局的定义，按严重程度对报告的副作用进行了分类。使用 IBM SPSS Statistics 20 版进行了统计分析。在刺激测试期间注意到了各种副作用，这些副作用因强度、持续时间和严重程度而异，具体取决于所使用的物质类型和协议。五肽胃泌素试验后的副作用比钙刺激试验后报告的副作用严重得多（p=0.0396）。刺激试验引起的副作用也存在显着的性别差异。总之，我们建议在需要时进行 Ca CT 刺激试验，同时考虑对每位患者的一些临床、仪器和生化方面的预防性评估。在刺激测试之前应遵循精确的说明，此外，在测试期间和之后必须进行持续的心脏监测，以尽量减少发生严重事件的可能性。