title: Zollinger-Ellison syndrome in a patient with normal screening gastrin level.
abstract: A 59-year-old female presented with multifocal peptic ulcer disease and diarrhea. A fasting serum gastrin level obtained while the patient was receiving no antacid therapy was normal. A secretin stimulation test was positive. A small gastrinoma was found in the anterior duodenal wall at exploratory laparotomy. Normal fasting gastrin levels do occur in patients with overt Zollinger-Ellison syndrome and should not deter further investigation if clinical suspicion of this syndrome is high.
authors.affiliation: Department of Medicine, University of California, San Francisco.
authors.forename: R J
authors.initials: RJ
authors.lastname: Yanda
authors.forename: J W
authors.initials: JW
authors.lastname: Ostroff
authors.forename: C D
authors.initials: CD
authors.lastname: Ashbaugh
authors.forename: M S
authors.initials: MS
authors.lastname: Guis
authors.forename: H I
authors.initials: HI
authors.lastname: Goldberg
mesh_terms: D004379:Duodenal Neoplasms / Q000097:blood* / Q000175:diagnosis; D005260:Female; D015408:Gastrinoma / Q000097:blood* / Q000175:diagnosis; D005755:Gastrins / Q000097:blood*; D006801:Humans; D008875:Middle Aged; D015043:Zollinger-Ellison Syndrome / Q000097:blood* / Q000175:diagnosis
chemical_list: D005755:Gastrins