Zollinger-Ellison syndrome type 1: clinical and pathological correlations in a case.
Some patients with the Zollinger-Ellison syndrome appear to have hypergastrinaemia and hyperplasia of the antral G cells but no tumour. This subgroup has been classified as Zollinger-Ellison syndrome type 1. We have treated such a patient by vagotomy and antrectomy, the fasting plasma gastrin and acid secretion subsequently returning to normal.A 17-year-old male had a four-year history of duodenal ulcer. Gastric secretion tests showed acid hypersecretion. Fasting plasma gastrin was 8350 pg/ml (normal 50-170 pg/ml). At laparotomy duodenal ulceration was confirmed but no pancreatic or other tumours were found. Truncal vagotomy and antrectomy was performed with distal pancreatectomy. Immunofluorescent staining showed hyperplasia of G cells in the resected antrum but a normal pancreas and duodenum. Six months after operation he was symptom free and acid secretion was reduced by 92%. The fasting plasma gastrin at two months was <50 pg/ml. These findings suggest that type 1 Zollinger-Ellison syndrome may be a clinical entity.
D000293:Adolescent; D004381:Duodenal Ulcer / Q000601:surgery; D005455:Fluorescent Antibody Technique; D005750:Gastric Juice / Q000378:metabolism; D005755:Gastrins / Q000097:blood; D006801:Humans; D006965:Hyperplasia; D007515:Islets of Langerhans; D008297:Male; D008854:Microscopy, Electron; D010179:Pancreas / Q000473:pathology; D011706:Pyloric Antrum / Q000473:pathology / Q000601:surgery; D014628:Vagotomy; D015043:Zollinger-Ellison Syndrome / Q000175:diagnosis / Q000473:pathology / Q000601:surgery
D005755:Gastrins