Comparative study of the value of the calcium, secretin, and meal stimulated increase in serum gastrin to the diagnosis of the Zollinger-Ellison syndrome.

Abstract

SUMMARY To evaluate the usefulness of provocation tests in the diagnosis of the Zollinger-Ellison (ZE) syndrome stimulation tests with calcium, 15 mg/kg.3 h, and secretin GIH, 1 U/kg.30 s, were performed in 15 patients with histologically proven or suspected ZE syndrome. Nine of these 15 patients were without previous gastric surgery and in them meal stimulated serum gastrin levels were measured as well. These tests were also performed in normal subjects and in patients with duodenal ulcer, antrectomy, total gastrectomy, and achlorhydria. All tests were considered to be positive if a more than a 50 % increase in serum gastrin was found. The results indicate that secretin stimulation is the provocation test of first choice in the diagnosis of this syndrome. This test is most valuable for the following reasons: (1) there were few (two out of 15) false-negative test results in ZE patients; (2) there were no false-positive tests in 69 patients without gastrinoma; (3) it was easy and quick to perform; and (4) there were no adverse reactions. The two ZE patientswithnegativesecretinstimulation tests had negative calcium provocation tests as well, in spite of histologically proven gastrinoma. In 11 patients with suspected or proven ZE syndrome and basal serum gastrin levels of less than 1000 pg/ml a rather good correlation (r = 0-841; p < 0 01) was found between the percental increase in serum gastrin after stimulation by calcium and secretin. Meal stimulated serum gastrin levels are helpful only in patients without previous gastric surgery.

Hypochlorhydria and hypergastrinaemia in rheumatoid arthritis.

“…All patients met the criteria of the American Rheumatism Association for the diagnosis of classical or definite rheumatoid arthritis (Ropes et al, 1959 Fasting serum gastrin was measured by a radioimmunoassay technique (Stadil and Rehfeld, 1973;Lamers and van Tongeren, 1977). The gastrin antiserum was raised in a rabbit against synthetic human gastrin I containing residues 2 through 17 (SHG 2-17, Imperial Chemical Industries Ltd.) conjugated to bovine albumin.…”

Cephalic Stimulation of Gallbladder Contraction in Humans: Role of Cholecystokinin and the Cholinergic System

“…The intraassay variation ranged from 4.6 to 11.5% and the interassay variation from 11.3 to 26.1 %. Plasma gastrin was measured by radioimmu noassay as described previously [19]. Blood samples were measured in duplicate.…”

Effects of Neuromedin B and GRP-10 on Gastrin and Insulin Release from Cultured Tumor Cells of a Malignant Gastrinoma.

“…Gastrin release from this tumor is abnormal; it is not suppressed by secretin (Lamers and Van Tongeren, 1977;McGuigan and Wolfe, 1980), and is weakly stimulated by bombesin (Basso et al, 1981;Jansen and Lamers, 1982). Neuromedin B and C-terminal decapeptide of gastrin releasing peptide (GRP-10) are mammalian bombesin-like peptides (Mina-mino et al, 1983;Okada et al, 1984;Reeve et al, 1983) which stimulate the release of gastrin, insulin and glucagon in a similar manner to bombesin (Spindel, 1986;Kawai et al, 1988).…”