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Diagnosis and differential diagnosis of hypergastrinemia

Diagnose und Differentialdiagnose der Hypergastrinämie

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Zusammenfassung

Die häufigste Ursache für einen erhöhten Gastrinspiegel beim Menschen sind das Zollinger-Ellison Syndrom mit autonomer Gastrinüberproduktion durch einen Tumor und die reaktive Hypergastrinämie im Rahen einer chronisch atrophen Autoimmun-(Typ A) Gastritis. Die Achlorhydrie bewirkt eine vermehrte Gastrinausschüttung durch die antralen G-Zellen. Die Entitäten unterscheiden sich durch den pH Wert der Magensäure. Dieser ist < 2 bei Vorliegen eines Zollinger-Ellison Syndroms und neutral bei der Typ A Gastritis. Die Behandlung mit Protonen Pumpen Inhibitoren, eine Magenausgangsstenose, eine Vagotomie, chronische Niereninsuffizienz oder ein Kurzdarmsyndrom können mit einer milden Hypergastrinämie ohne klinische Relevanz einhergehen.

Summary

The most frequent conditions of hypergastrinemia in man are the Zollinger-Ellison syndrome with autonomous gastrin hypersecretion by the tumour cell and reactive hypergastrinemia in type A autoimmune chronic atrophic gastritis with achlorhydria causing unrestrained gastrin release from the gastrin-producing antral G-cells. Both entities differ with respect to the pH in the gastric fluid, which is < 2 in patients with Zollinger-Ellison syndrome and neutral in type A gastritis. Other conditions with moderate hypergastrinemia as treatment with proton pump inhibitors, gastric outlet obstruction, previous vagotomy, chronic renal failure or short bowel syndrome are of minor clinical importance.

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  1. Klinik für Innere Medizin, Schwerpunkt Gastroenterologie und Endokrinologie, Klinikum Giessen-Marburg, Standort Marburg, Philipps Universität, Marburg, Germany

    Rudolf Arnold

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  1. Rudolf Arnold
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Correspondence to Rudolf Arnold.

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Arnold, R. Diagnosis and differential diagnosis of hypergastrinemia. Wien Klin Wochenschr 119, 564–569 (2007). https://doi.org/10.1007/s00508-007-0878-0

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  • DOI: https://doi.org/10.1007/s00508-007-0878-0

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