Pepsin acid correlation in patients with Zollinger-Ellison syndrome

In 3 patients with Zollinger-Ellison syndrome, gastric pepsin and acid secretion, and pepsin acid correlation were studied. The results obtained are as follows. In nocturnal secretion, and histamine-, insulin- and gastrin-stimulated secretion, pepsin hypersecretion was not as conspicuous as acid hypersecretion, and so pepsin acid correlation showed low levels of less than 1.0. Not only before operation but also after vagotomy or distal gastrectomy, the same results were obtained. These results suggest that both before and after operation Zollinger-Ellison syndrome should be suspected in patients with pepsin acid correlation of less than 1.0 in nocturnal secretion or stimulated secretion.