Gastrin Response to Calcium Infusion: An Aid to the Improved Diagnosis of Zollinger-Ellison Syndrome in Children

PEDIATRICS ◽  
1974 ◽  
Vol 54 (5) ◽  
pp. 599-602
Author(s):  
David L. Schwartz ◽  
John J. White ◽  
Frank Saulsbury ◽  
J. Alex Haller
Keyword(s):  
Serum Gastrin ◽  
Islet Cell Tumor ◽  
Elevated Serum ◽  
Cell Tumor ◽  
Infusion Test ◽  
Fasting Serum ◽  
Zollinger Ellison Syndrome ◽  
Weight One ◽  
Calcium Infusion ◽  
One Year

Serum gastrin levels were equivocally elevated in a 9-year-old boy with suspected Zollinger-Ellison syndrome. He had copious hyperacidity on fasting gastric analysis which was increased insignificantly following histamine administration. A calcium infusion test produced diagnostically elevated serum gastrin values (average 400 pg/ml) which were sustained for the course of the four-hour infusion. A malignant islet cell tumor of the pancreas metastatic to a celiac lymph node was found, and total gastrectomy performed. The boy adjusted well and is gaining along his curves for height and weight one year postoperatively. The calcium infusion test, or its counterpart the calcium challenge, appears to be a helpful method for identifying the Zollinger-Ellison syndrome, particularly in children in whom fasting serum gastrin values may not be diagnostic by adult standards.

Zollinger-Ellison Syndrome in a Nineyear -old Child: A Case Report and Review of this Entity in Childhood

PEDIATRICS ◽  
1971 ◽  
Vol 47 (3) ◽  
pp. 594-598
Author(s):  
Richard M. Buchta ◽  
J. M. Kaplan
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Clinical Data ◽  
Islet Cell ◽  
Islet Cell Tumor ◽  
Cell Tumor ◽  
Gastric Hypersecretion ◽  
Zollinger Ellison Syndrome ◽  
History Of ◽  
Epigastric Abdominal Pain

In 1955, Zollinger and Ellison1 described a syndrome consisting of peptic ulceration, marked gastric hypersecretion, and non-beta islet cell tumor of the pancreas. Although there have been over 300 cases in the adult literature2-5 only 19 patients, 16 years old or younger have been reported. We add one more child to this growing list and review the clinical data of the known cases described. Case Report The patient (R.L.) was a 9-year-old Negro male with a 7-month history of intermittent episodes of mid-epigastric abdominal pain. The pain was somewhat relieved by eating, or the use of antispasmodics. During this period of time, the child had occasional episodes of vomiting, but no melena or hematemesis.

Elevated serum calcitonin levels in patients with thyroid disorders

1984 ◽  
Vol 107 (4) ◽  
pp. 476-481 ◽  
Author(s):  
Seiichi Oishi ◽  
Tatsuya Shimada ◽  
Junichi Tajiri ◽  
Junnosuke Inoue ◽  
Tatsuo Sato
Keyword(s):  
Thyroid Carcinoma ◽  
Elevated Serum ◽  
Normal Subjects ◽  
Thyroid Disorders ◽  
Infusion Test ◽  
Serum Calcitonin ◽  
Medullary Thyroid ◽  
Before And After ◽  
Calcium Infusion ◽  
Calcium Load

Abstract. Serum calcitonin was measured by radioimmunoassay (RIA) in 63 patients with hyperthyroidism, 37 with hypothyroidism, 9 with surgically proven medullary thyroid carcinoma (MTC) and 81 normal subjects. Provocative tests of calcitonin by calcium infusion were performed in 11 with hyperthyroidism, 10 with hypothyroidism, 6 with MTC and 14 normal subjects. Changes of calcitonin were also studied before and after treatment in 17 patients with hyperthyroidism and 12 with hypothyroidism. The basal calcitonin levels were increased in both hyperthyroidism (117 ± 60.1 pg/ml (mean ± sd): n = 63, P < 0.001) and hypothyroidism (137 ± 107 pg/ml, n = 37, P < 0.001), and significantly increased in MTC 14765 ± 25039 pg/ml, range 390 to 70400 pg/ml, n = 9, P < 0.001) compared with those in normal subjects (45.8 ± 22.3 pg/ml, n = 81). Increases of calcitonin during calcium load (iv 4.5 mg calcium/kg for 10 min) were significantly lower in both hyperthyroidism and hypothyroidism patients than in those in MTC. The calcitonin levels were not correlated with the serum T3, T4, TSH concentrations or titres of serum antithyroid antibodies in hyperthyroidism and hypothyroidism. We found some tendency toward decreasing calcitonin levels with the euthyroid state after treatment in both groups, but the changes were not significant. Although exact mechanisms of increased calcitonin in hyperthyroidism and hypothyroidism were not clear, our findings suggest that a 2- to 3-fold elevation of calcitonin levels in these patients did not indicate malignancy; MTC could be readily differentiated by a calcium infusion test.

Prognostic Value of Initial Fasting Serum Gastrin Levels in Patients With Zollinger-Ellison Syndrome

2001 ◽  
Vol 19 (12) ◽  
pp. 3051-3057 ◽  
Author(s):  
Adam C. Berger ◽  
Fathia Gibril ◽  
David J. Venzon ◽  
John L. Doppman ◽  
Jeffrey A. Norton ◽  
...  
Keyword(s):  
Lymph Node ◽  
Liver Metastases ◽  
Tumor Size ◽  
Primary Tumor ◽  
Serum Gastrin ◽  
Hepatic Metastases ◽  
Initial Evaluation ◽  
Fasting Serum ◽  
Men 1 ◽  
Zollinger Ellison Syndrome

PURPOSE: To assess the value of the initial fasting serum gastrin (FSG) at presentation in patients with Zollinger-Ellison Syndrome (ZES) in predicting primary tumor characteristics and survival. PATIENTS AND METHODS: A total of 239 patients were treated for ZES between December 1981 and September 1998, with a mean follow-up of 9.1 ± 0.6 years. At initial evaluation, 86 patients (36%) had mild (0 to 499 pg/mL), 61 (25.5%) had moderate (500 to 1,000 pg/mL), and 92 (38.5%) had severe (> 1,000 pg/mL) elevations in FSG. Primary tumor location and size, presence of lymph node or hepatic metastases, and survival were analyzed based on the level of initial FSG. RESULTS: In patients with sporadic ZES, but not in those with multiple endocrine neoplasia type 1 (MEN-1) and ZES, there was a significant relationship between the level of initial FSG and tumor size and location of primary tumor, frequency of lymph node and liver metastases, and survival. The median 5- and 10-year survival decreased with increasing initial FSG (P < .001) in patients with sporadic ZES; MEN-1 patients lived longer than sporadic ZES patients (P = .012), and survival in this group was not associated with the level of initial FSG. Multivariate analysis showed that factors independently associated with death from disease in patients with sporadic ZES were liver metastases (P = .0001), a pancreatic site (P = .0027), and primary tumor size (P = .011) but not initial FSG (P > .30). CONCLUSION: The severity of FSG at presentation is associated with size and site of tumor and the presence of hepatic metastases, factors that are significant independent predictors of outcome. The level of FSG at presentation may be useful in planning the nature and extent of the initial evaluation and management in patients with sporadic ZES.

scholarly journals S3070 Zollinger-Ellison Syndrome: A Fasting Serum Gastrin Level Is Not Enough

2021 ◽  
Vol 116 (1) ◽  
pp. S1267-S1267
Author(s):  
Ann Saliares ◽  
Veena Janardan ◽  
Fadi Hawa ◽  
Naresh Gunaratnam
Keyword(s):  
Serum Gastrin ◽  
Gastrin Level ◽  
Serum Gastrin Level ◽  
Fasting Serum ◽  
Zollinger Ellison Syndrome

Insulin and proinsulin release during calcium infusion in a patient with islet-cell tumor

Metabolism ◽  
1975 ◽  
Vol 24 (9) ◽  
pp. 1029-1034 ◽  
Author(s):  
Richard F. Gaeke ◽  
Edwin L. Kaplan ◽  
Arthur Rubenstein ◽  
Jerome Starr ◽  
Gerald Burke
Keyword(s):  
Islet Cell ◽  
Islet Cell Tumor ◽  
Cell Tumor ◽  
Calcium Infusion

Gastrinoma: a retrospective study of four cases (1985-1995)

1997 ◽  
Vol 33 (6) ◽  
pp. 524-527 ◽  
Author(s):  
RA Green ◽  
CL Gartrell
Keyword(s):  
Veterinary Medicine ◽  
Retrospective Study ◽  
Islet Cell ◽  
Serum Gastrin ◽  
Elevated Serum ◽  
Islet Cell Tumors ◽  
Zollinger Ellison Syndrome ◽  
Exploratory Surgery

Islet-cell tumors of the pancreas, such as gastrinoma, are rare in veterinary medicine. Patients with gastrinoma or Zollinger-Ellison syndrome have elevated serum gastrin levels which ultimately cause gastrointestinal ulcerations. Due to their small size, gastrinomas are a challenge to localize prior to surgery. In veterinary medicine, exploratory surgery with biopsy for histopathology confirms the diagnosis of gastrinoma. This is a retrospective study of four dogs with gastrinoma.

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