The effect of cimetidine and propantheline on the symptoms of a patient with systemic mastocytosis.
A 24 year old white woman with a lifelong history of systemic mastocytosis and symptoms of diarrhea and flushing was demonstrated to have a normal gastric analysis and inconsistent steatorrhea. She responded well to oral cimetidine therapy for 11 months. A symptomatic recurrence was controlled with the addition of propantheline. Gastric secretory studies demonstrated cimetidine suppression of both basal acid and basal pepsin secretion, as well as maximal pentagastrin-stimulated acid secretion; suppression of stimulated pepsin secretion was minimal. The combination of cimetidine and propantheline markedly suppressed both peak acid and peak pepsin secretion in response to pentagastrin stimulation. These data support a dominant role of cholinergic mechanisms in the control of gastric pepsin secretion; additional data obtained with maintenance of constant intragastric pH are required for further clarification.
D000328:Adult; D002446:Celiac Disease / Q000150:complications; D002927:Cimetidine / Q000627:therapeutic use*; D003967:Diarrhea / Q000150:complications; D005260:Female; D005750:Gastric Juice / Q000378:metabolism; D006146:Guanidines / Q000627:therapeutic use*; D006801:Humans; D010434:Pepsin A / Q000378:metabolism; D011413:Propantheline / Q000627:therapeutic use*; D012008:Recurrence; D014582:Urticaria Pigmentosa / Q000150:complications / Q000188:drug therapy*
D006146:Guanidines; D011413:Propantheline; D002927:Cimetidine; D010434:Pepsin A