Secretin-Stimulated Serum Gastrin Levels in Hyperparathyroid Patients from Families with Multiple Endocrine Adenomatosis Type I

Abstract

Patients (23) with hyperparathyroidism from 6 families with the multiple endocrine adenomatosis (MEA) syndrome were tested by secretin provocation. In 9 cases this led to increases in serum gastrin ranging from 298-13,300 pg/ml, whereas the maximum rise in gastrin in the other 14 patients was 32 pg/ml. In all 9 patients with marked gastrin responses to secretin, the Zollinger-Ellison syndrome was diagnosed by gastric acid hypersecretion and large increases in gastrin after Ca administration. Six of these 9 patients had minor postprandial rises in gastrin and 2 had demonstrable tumors. In 34 normal subjects, 23 nonaffected members of families with MEA I-syndrome and 42 patients with various diseases the maximum gastrin response to secretin was 21 pg/ml. Secretin provocation is helpful in the diagnosis of the Zollinger-Ellison syndrome, especially when basal serum gastrin levels are only slightly elevated.