Zollinger-Ellison syndrome laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Mohamad Alkateb, MBBCh [2]

Overview

An elevated concentration of fasting serum gastrin level is diagnostic of Zollinger-Ellison syndrome. Secretin stimulation test is also used to diagnose Zollinger-Ellison syndrome.

Laboratory Findings

Laboratory findings consistent with the diagnosis of Zollinger-Ellison syndrome include:[1][2][3][4]

  • Gastrin level ≥ 120 pg/mL
  • For accurate results, gastric antisecretory medications should be stopped
  • Serum calcium:
  • Increased levels of serum calcium may suggest multiple endocrine neoplasia type 1 (MEN1)
  • Gastric acid secretion tests:
  • Basal acid output
  • Basal gastric secretory volume
  • Gastric pH ≤ 2 is highly suggestive of Zollinger-Ellison syndrome
  • Provocative tests:
  • Secretin stimulation test (test of choice)
  • Calcium stimulation test
  • Secretin plus calcium stimulation tests

References

  1. Berna MJ, Hoffmann KM, Long SH, Serrano J, Gibril F, Jensen RT (2006). "Serum gastrin in Zollinger-Ellison syndrome: II. Prospective study of gastrin provocative testing in 293 patients from the National Institutes of Health and comparison with 537 cases from the literature. evaluation of diagnostic criteria, proposal of new criteria, and correlations with clinical and tumoral features". Medicine (Baltimore). 85 (6): 331–64. doi:10.1097/MD.0b013e31802b518c. PMID 17108779.
  2. Roy PK, Venzon DJ, Feigenbaum KM, Koviack PD, Bashir S, Ojeaburu JV; et al. (2001). "Gastric secretion in Zollinger-Ellison syndrome. Correlation with clinical expression, tumor extent and role in diagnosis--a prospective NIH study of 235 patients and a review of 984 cases in the literature". Medicine (Baltimore). 80 (3): 189–222. PMID 11388095.
  3. Romanus ME, Neal JA, Dilley WG, Leight GS, Linehan WM, Santen RJ; et al. (1983). "Comparison of four provocative tests for the diagnosis of gastrinoma". Ann Surg. 197 (5): 608–17. PMC 1353045. PMID 6847280.
  4. Tomassetti P, Campana D, Piscitelli L, Mazzotta E, Brocchi E, Pezzilli R; et al. (2005). "Treatment of Zollinger-Ellison syndrome". World J Gastroenterol. 11 (35): 5423–32. PMC 4320348. PMID 16222731.

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