Zollinger-Ellison Syndrome: Provocative Diagnostic Tests

Excerpt

Features of the Zollinger-Ellison syndrome (gastrinoma) include peptic ulcer disease, basal acid hypersecretion, and fasting hypergastrinemia. Its diagnosis is strongly supported by a serum gastrin concentration above 500 pg/ml in the absence of achlorhydria or renal failure. Such marked elevations of serum gastrin are not present in all gastrinoma patients, however. About 40% will have a fasting gastrin concentration of 100 to 500 pg/ml, whereas about 10% of ulcer patients without evidence of gastrinoma have fasting gastrin concentrations in that range. Therapy for ordinary peptic ulcer differs from that for the Zollinger-Ellison syndrome medically—short-term antacid or Cimetidine treatment rather than