Misdiagnosis of the Zollinger-Ellison syndrome due to hyperlipidemia.
Most authorities feel that diagnosis of the Zollinger-Ellison syndrome is established when the serum gastrin level is greater than 1000 pg/mL (1000 ng/L) in a patient with gastric acid hypersecretion and clinical manifestations consistent with the diagnosis. A patient with recurrent peptic ulcer disease is reported who was thought to have had the Zollinger-Ellison syndrome based on two serum gastrin level measurements greater than 1000 pg/mL (1000 ng/L). Subsequent evaluation revealed the gastrin elevation to be spurious because the sample was hyperlipidemic. Lipemic serum samples may yield falsely elevated serum gastrin determinations as determined by radioimmunoassay.
Department of Medicine, Cincinnati Department of Veterans Affairs Medical Center, Ohio.
D P
DP
Romeo
R E
RE
Weesner
R A
RA
Giannella
D003951:Diagnostic Errors; D016099:Endoscopy, Gastrointestinal; D005755:Gastrins / Q000097:blood*; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications*; D008297:Male; D008875:Middle Aged; D015043:Zollinger-Ellison Syndrome / Q000150:complications / Q000175:diagnosis*
D005755:Gastrins