Document Detail


Review article: Strategies to determine whether hypergastrinaemia is due to Zollinger-Ellison syndrome rather than a more common benign cause.
MedLine Citation:
PMID:  19226290     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
S V M Murugesan; A Varro; D M Pritchard
Publication Detail:
Type:  Journal Article; Review     Date:  2009-02-18
Journal Detail:
Title:  Alimentary pharmacology & therapeutics     Volume:  29     ISSN:  1365-2036     ISO Abbreviation:  Aliment. Pharmacol. Ther.     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-04-21     Completed Date:  2009-10-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8707234     Medline TA:  Aliment Pharmacol Ther     Country:  England    
Other Details:
Languages:  eng     Pagination:  1055-68     Citation Subset:  IM    
Affiliation:
School of Clinical Sciences, University of Liverpool, Liverpool, UK.
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MeSH Terms
Descriptor/Qualifier:
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:
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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