Summary
A 59-year-old female presented with multifocal peptic ulcer disease and diarrhea. A fasting serum gastrin level obtained while the patient was receiving no antacid therapy was normal. A secretin stimulation test was positive. A small gastrinoma was found in the anterior duodenal wall at exploratory laparotomy. Normal fasting gastrin levels do occur in patients with overt Zollinger-Ellison syndrome and should not deter further investigation if clinical suspicion of this syndrome is high.
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References
Zollinger RM, Ellison EH: Primary peptic ulceration of the jejunum associated with islet cell tumors of the pancreas. Ann Surg 142:709–728, 1955
Gregory RA, Tracy HJ: The constitution and properties of two gastrins extracted from hog antral mucosa. Gut 5:103–114, 1964
Marks IN, Selzer G, Louw JH, et al: Zollinger-Ellison syndrome in a Bantu woman, with isolation of a gastrin-like substance from the primary and secondary tumors. Gastroenterology 41:77–86, 1961
McGuigan JE, Trudeau WL: Immunochemical measurement of elevated levels of gastrin in the serum of patients with pancreatic tumors of the Zollinger-Ellison variety. N Engl J Med 278:1308–1313, 1968
Deveney CW, Deveney KS: Zollinger-Ellison syndrome. Surg Clin North Am 67(2):411–422, 1987
Walsh JH, Grossman MI: Gastrin. N Engl J Med 292:1324–1334, 1377–1384, 1975
Deveney CW, Deveney KS, Way LW: The Zollinger-Ellison syndrome: 23 years later. Ann Surg 188:384–393, 1978
Thompson JC, Reeder DD, Villar HV, Fender HR: Natural history and experience with diagnosis and treatment of the Zollinger-Ellison syndrome. Surg Gynecol Obstet 140:721–738, 1975
Bonfils S, Landor JH, Mignon MM, Hervoir P: Results of surgical management in 92 consecutive patients with Zollinger-Ellison syndrome. Ann Surg 194:692–697, 1981
Malagelada JR, Davis CS, O'Fallon WM, Go VL: Laboratory diagnosis of gastrinoma. Mayo Clin Proc 57:211–218, 1982
Mohammed R, Holden RJ, Hearns JB, McKibben BM, Buchanan KD, Crean GP: Effects of eight weeks' continuous treatment with oral ranitidine and cimetidine on gastric acid secretion, pepsin secretion, and fasting serum gastrin. Gut 24:61–66, 1983
Bank S, Barbezat GO, Vinik AI, Helman C: Serum gastrin levels before and after 6 weeks of cimetidine therapy in patients with duodenal ulcer. Digestion 15:157–161, 1977
Larsson H, Carlsson E, Mattsson H, et al: Plasma gastrin and gastric enterochromaffin-like cell activation and proliferation. Gastroenterology 90:391–399, 1986
McGuigan JE, Wolfe MM: Secretin injection test in the diagnosis of gastrinoma. Gastroenterology 79:1324–1331, 1980
Feldman M, Schiller LR, Walsh JH, Fordtran JS, Richardson CT: Positive intravenous secretin test in patients with achlorhydria-related hypergastrinemia. Gastroenterology 93:59–62, 1987
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Yanda, R.J., Ostroff, J.W., Ashbaugh, C.D. et al. Zollinger-Ellison syndrome in a patient with normal screening gastrin level. Digest Dis Sci 34, 1929–1932 (1989). https://doi.org/10.1007/BF01536714
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DOI: https://doi.org/10.1007/BF01536714