| Review article: Strategies to determine whether hypergastrinaemia is due to Zollinger-Ellison syndrome rather than a more common benign cause. | |
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MedLine Citation:
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PMID: 19226290 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: As there is considerable overlap between the fasting serum gastrin concentrations found in Zollinger-Ellison syndrome and various common conditions such as Helicobacter pylori infection and acid suppressing medication use, establishing the cause of hypergastrinaemia in individual cases can sometimes be difficult. AIM: To review the causes of hypergastrinaemia and the role of additional non-invasive investigations in hypergastrinaemic patients. METHODS: Review of articles following a Pubmed search. RESULTS: As gastrinomas may cause serious complications and be potentially life threatening, investigation of hypergastrinaemic patients should particularly focus on confirming or refuting the diagnosis of Zollinger-Ellison syndrome. Establishing the cause of hypergastrinaemia may be difficult when there is only a mild-to-moderate elevation of fasting serum gastrin concentration and concurrent treatment with proton pump inhibitor drugs and the presence of H. pylori infection can both confuse the clinical picture. A variety of provocative tests are therefore useful for establishing whether a hypergastrinaemic patient has a gastrinoma and current evidence suggests that the secretin test should be used first line. CONCLUSIONS: We suggest an algorithm for the investigation of patients found to have an elevated fasting serum gastrin concentration and address the roles of gastrin stimulation tests in current clinical practice. |
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Authors:
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S V M Murugesan; A Varro; D M Pritchard |
Publication Detail:
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Type: Journal Article; Review Date: 2009-02-18 |
Journal Detail:
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Title: Alimentary pharmacology & therapeutics Volume: 29 ISSN: 1365-2036 ISO Abbreviation: Aliment. Pharmacol. Ther. Publication Date: 2009 May |
Date Detail:
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Created Date: 2009-04-21 Completed Date: 2009-10-09 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8707234 Medline TA: Aliment Pharmacol Ther Country: England |
Other Details:
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Languages: eng Pagination: 1055-68 Citation Subset: IM |
Affiliation:
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School of Clinical Sciences, University of Liverpool, Liverpool, UK. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Algorithms Diagnosis, Differential Gastrinoma / etiology* Gastrins / metabolism* Gastrointestinal Agents / adverse effects* Helicobacter Infections / diagnosis* Helicobacter pylori / isolation & purification Humans Secretin / metabolism* Zollinger-Ellison Syndrome / complications* |
| Chemical | |
Reg. No./Substance:
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0/Gastrins; 0/Gastrointestinal Agents; 1393-25-5/Secretin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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