Calcium and Secretin-Stimulated Gastrin Release in the Zollinger-Ellison Syndrome

Abstract

Serum gastrin and calcium concentrations were measured and compared before and after calcium and secretin infusions in three patients with the Zollinger-Ellison syndrome and three control subjects. Calcium infusion induced marked increases in serum gastrin concentrations in the patients with Zollinger-Ellison syndrome (increases 3100 to 19 000 pg/ml) and modest increases in the control subjects (mean increase, 29 pg/ml). In each patient with Zollinger-Ellison syndrome who received calcium infusion there was a significant (P < 0.001) positive correlation (r from +0.91 to +0.95) between serum gastrin and calcium levels. Intravenous secretin also produced increases in both serum gastrin and calcium in each patient with Zollinger-Ellison syndrome; however, there was not a positive correlation between serum gastrin and calcium. These studies affirm secretin-induced paradoxical augmentation of serum gastrin in patients with Zollinger-Ellison syndrome. Failure to show positive correlation between serum gastrin and calcium with secretin administration, as is readily demonstrable with calcium infusion, provides no support for serum calcium increases as the mechanism by which serum gastrin is increased after secretin infusion in patients with Zollinger-Ellison syndrome.