It was unfortunate that this patient was lost to follow up prior to secretin stimulation testing being performed as suspicion for Zollinger-Ellison syndrome
may happen in people with gastrin-producing NETs of the pancreas or small intestine (gastrinoma).
Primary site Pancreas Gastrointestinal tract (ileum, stomach, and appendix) Number of pts 37 27 Age median (range) 59.5 (30-79) 57(21-78) 9 insulinoma -- Syndrome 1 carcinoid syndrome 2 carcinoid syndrome 1 ZES 1 ZES Stage I-II: 22 I-II: 10 IIIB-IV: 15 IIIB-IV: 17 Ki67 median (range) 1.8% (0.1-18.8%) 2.3% (0.5-12.4%) Grading G1: 21 (56.8%) G1: 18 (66.7%) G2: 16 (43.2%) G2: 9 (33.3%) Follow-up Median 69.5 months (range: 4-140 months) Primary site Total Number of pts 64 (M: 26) Age median (range) 59 (21-79) 9 insulinoma Syndrome 3 carcinoid syndrome 2 ZES Stage I-II: 32 IIIB-IV: 32 Ki67 median (range) 1.8% (0.1-18.8%) Grading G1: 39 (60.9%) G2: 25 (39.1%) Follow-up ZES: Zollinger-Ellison syndrome
. TABLE 2: Subgroup comparisons of SSTR2A, IGF-1R, and p-mTOR QSs.
Shojamanesh et al., "Zollinger-Ellison syndrome
. Clinical presentation in 261 patients," Medicine, vol.
Starr et al., "Intravenous pantoprazole rapidly controls gastric acid hypersecretion in patients with Zollinger-Ellison syndrome
," Gastroenterology, vol.
The Zollinger-Ellison syndrome
: a comprehensive review of historical, scientific, and clinical considerations.
Type-II ECL-cell NETs occur in patients with MEN1 or Zollinger-Ellison syndrome
. MEN1 is a tumor suppressor gene on band 11q13 that encodes the menin protein.
: Zollinger-Ellison syndrome
is a disorder characterized by excessive secretion of gastrin hormone.
Doctors prescribe PPIs to treat a wide range of disorders, including gastro-esophageal reflux disease, or GERD, infection by the ulcer-causing bacterium Helicobacter pylori, Zollinger-Ellison syndrome
, and Barrett's esophagus.
These tests may include stool and blood testing, a lower Gl series, upper endoscopy, flexible sigmoidoscopy, or colonoscopy.2 Differential diagnosis of IBS includes SIBO, carbohydrate/fructose malabsorption, lactose intolerance, yeast overgrowth or hypersensitivity, parasitic infection, large intestine bacterial overgrowth or infection, abdominophrenic dyssynergia, celiac disease, IBD: Crohn's/ulcerative colitis, VIPoma, Zollinger-Ellison syndrome
, cancer (pancreatic, stomach, small intestine), H.
1) is a histamine H2 receptor inhibitor which blocks the production of the acid secreted by the stomach and used for the treatment of peptic ulcer disease, gastro esophageal reflux disease and Zollinger-Ellison syndrome
. It was rapidly and orally well absorbed.
Finally, the Zollinger-Ellison syndrome
(ZES)(4) turned out to be caused by gastrinomas (9) that required gastrin measurements for proper diagnosis.