Zollinger-Ellison Syndrome
Advances in Treatment of Gastric Hypersecretion and the Gastrinoma
- Robert T. Jensen, MD;
- Douglas L. Fraker, MD
Since this article does not have an abstract, we have provided the first 150 words of the full text.
Excerpt
Case 1 A 56-year-old man had an 8-year history of heartburn and diarrhea (three to four loose bowel movements a day) and a 3-year history of epigastric pain with two episodes of melena. Upper gastrointestinal endoscopy demonstrated a duodenal ulcer; however, no Helicobacter pylon was seen on the biopsy specimen. He was treated with ranitidine. Pain recurred when ranitidine administration was stopped. Despite visits to a number of physicians, the diagnosis of Zollinger-Ellison syndrome (ZES) was not made until 1 month before he was referred to the National Institutes of Health (NIH), when he was found to have an elevated fasting gastrin level and a gastric pH less than 2.5. Fasting gastrin at the NIH was elevated at 363 ng/L (normal, <100 ng/L), and basal acid output (BAO) was 46 mEq/h (normal, <10 mEq/h). Results of the secretin-provocative test were positive, with a baseline value of 352 ng/L increasing to
Footnotes
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Reprint requests to National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bldg 10, Room 9C-103, Bethesda, MD 20892 (Dr Jensen).
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Grand Rounds at the Clinical Center of the National Institutes of Health section editors: Saul Rosen, PhD, MD, the Clinical Center of the National Institutes of Health, Bethesda, Md; David S. Cooper, MD, Contributing Editor, JAMA.
