Clinical significance of glucagon provocation test in the diagnosis of hypergastrinemia

Abstract

Glucagon provocation test was performed in the patients with hypergastrinemia and hyperchlorhydria to investigate its diagnostic value. A paradoxical response of plasma gastrin level in the patients with the Zollinger-Ellison syndrome and a marked decrease of plasma gastrin level in the patients with gastric ulcer, duodenal ulcer, excluded gastric antrum, multiple endocrine adenomatosis, pernicious anemia and chronic renal failure were demonstrated by glucagon infusion. Glucagon provocation test, therefore, was considered to be of great value in the diagnosis of the Zollinger-Ellison syndrome, particularly, in the case of an excluded gastric antrum in which secretin provocation test caused the false positive result because of a marked increase of pancreatic secretion. Glucagon provocation test in combination with secretin provocation test, therefore, is at present the most preferable diagnostic procedure for detecting the Zollinger-Ellison syndrome.U

Somatostatinoma syndrome accompanied by overproduction of pancreatic polypeptide.

“…Secretin test for the measurement of plasma pancreatic polypeptide (PP) concentrations was done by a bolus injection of 50 U secretin. The glucagon test for the differentiation of hypergastrinemia was carried out as described earlier (Nakanome et al 1981). The tests mentioned above were performed before and after the operation except C-S test and secretin test.…”

“…Plasma hormone levels were assayed by specific radioimmunoassays for PP (Toyota et al 1980), glucagon (Toyota et al 1982), insulin (Toyota et al 1982), gastrin (Nakanome et al 1981), and growth hormone (Hanew et al 1980). Hormone content of the tumor was also analysed by radioimmunoassay for somatostatin (Yanaihara et al 1978), PP, vasoactive intestinal polypeptide (VIP, Yanaihara et al 1977), glucagon, /3-MSH, ACTH (Abe et al 1979), and gastrin.…”