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Pathological acid secretion not due to gastrinoma.
Scandinavian Journal of Gastroenterology. Supplement
|January 1, 1983
Summary
This study investigated pathological hypergastrinaemia in four patients with severe acid hypersecretion and peptic ulcers. Two cases showed antral gastrin cell hyperfunction, suggesting a new mechanism for hypergastrinaemia in ulcer disease.
Area of Science:
- Gastroenterology
- Endocrinology
- Pathophysiology
Background:
- Pathological hypergastrinaemia, particularly of antral origin, is infrequently studied.
- Peptic ulcer disease (PUD) can be associated with severe acid hypersecretion.
Observation:
- Four patients with severe acid hypersecretion and PUD, lacking gastrinoma or retained antrum, were identified.
- Three patients exhibited hypergastrinaemia; two showed evidence of antral gastrin cell hyperfunction and hyperplasia.
- One patient with hypersecretory ulcer disease showed resistance to cimetidine but responded to a potent H2 antagonist.
Findings:
- Two cases suggest antral gastrin cell hyperfunction as a cause of hypergastrinaemia in PUD.
- A potential primary intestinal gastrin cell hyperfunction syndrome was considered in another case.
- The study identified no unifying pathophysiological mechanism for hypergastrinaemia in these patients or broader PUD cohorts.
Implications:
- Highlights antral gastrin cell hyperfunction as a potential contributor to hypergastrinaemia and PUD.
- Underscores the need for further research into the diverse mechanisms of pathological hypergastrinaemia.
- Suggests tailored therapeutic approaches may be necessary for refractory hypersecretory states.