Hypergastrinemia in children with duodenal ulcer

Serum gastrin concentrations were determined in 25 children with duodenal ulcer (DU) and 25 normal children. Fasting values were significantly higher in DU children (mean +/- SE = 60.4 +/- 9.7 pg/mL) than in controls (mean +/- SE = 38.0 +/- 4.2 pg/mL; P less than .05). Integrated gastrin response to meal stimulation was also significantly higher in DU children (mean +/- SE = 140.5 +/- 32.4%) than in controls (mean +/- SE = 62.3 +/- 12.2%; P less than .05). Excessive gastrin activity (greater than normal mean + 2 SD), either fasting or meal-stimulated, occurred in 11 of 17 normal acid secretors and in two of eight hypersecretors in the DU group. The present findings suggest that excessive gastrin activity is a major factor in the pathogenesis of childhood DU. Unlike adult DU, which is associated with normal fasting gastrin concentrations, childhood DU manifests exaggerated gastrin activity both in the fasting and postprandial states.