Comparison of gastrointestinal loss of alpha-1-antitrypsin and chromium-51-albumin in Ménétrier's disease and the influence of ranitidine.
In a 37-year-old patient with Ménétrier's disease, 51Cr-albumin and alpha 1-antitrypsin (alpha 1-AT) output was measured simultaneously in gastric juice and feces. While the 51Cr-albumin studies demonstrated a threefold increase in gastrointestinal protein loss, alpha 1-AT was found in normal quantities in gastric juice and feces. The histamine H2 antagonist, ranitidine, led to a marked reduction in gastric protein loss, as evidenced by decreased 51Cr activity in the stomach. Studies of protein loss in the gastric juice during pentagastrin stimulation (6 micrograms/kg/h) showed that the 51Cr-albumin output paralleled the volume secreted, whereas alpha 1-AT decreased with lower pH values, not being detectable below pH 3. This probably results from peptic degradation of alpha 1-AT at low pH. We conclude that fecal alpha 1-AT determination cannot be used for the assessment of protein-losing gastropathy in patients who are not achlorhydric.
D000328:Adult; D000418:Albumins / Q000378:metabolism*; D002860:Chromium Radioisotopes; D004064:Digestive System / Q000378:metabolism*; D005243:Feces / Q000032:analysis; D005663:Furans / Q000494:pharmacology*; D005750:Gastric Juice / Q000378:metabolism; D005753:Gastric Mucosa / Q000378:metabolism; D005756:Gastritis / Q000378:metabolism*; D005758:Gastritis, Hypertrophic / Q000378:metabolism*; D006801:Humans; D008297:Male; D010418:Pentagastrin / Q000494:pharmacology; D011899:Ranitidine; D000515:alpha 1-Antitrypsin / Q000378:metabolism*
D000418:Albumins; D002860:Chromium Radioisotopes; D005663:Furans; D000515:alpha 1-Antitrypsin; D011899:Ranitidine; D010418:Pentagastrin