title: Serum gastrin and its response to secretin in hyperparathyroid patients.
abstract: In 36 patients with verified hyperparathyroidism (HPT), serum gastrin and its response to secretin was studied before and after parathyroidectomy. In most of the patients gastric secretion-basal acid output (BAO) and maximal acid output (MAO)--was also studied. Seventeen patients had increased serum gastrin values preoperatively and/or postoperatively. Most of the serum gastrin increases were moderate and all but one of the patients with values above 250 pmol/l had hypochlorhydria. Nine patients had a positive secretin test according to conventional criteria preoperatively or postoperatively, but showed no other signs suggestive of a gastrin-producing tumour. Most of the patients with a serum gastrin increase after injection of secretin had hypochlorhydria or achlorhydria. The BAO/MAO ratio was less than 0.6 in all patients. The results of this study do not support the view that primary HPT is often associated with a gastrin-producing tumour as part of a multiple endocrine adenomatosis (MEA type I), but indicate that the observed hypergastrinemia in HPT is almost exclusively related to hypo- or achlorhydria. The findings also give reason to doubt the value of the secretin test.
mesh_terms: D000236:Adenoma / Q000175:diagnosis; D005260:Female; D005744:Gastric Acid / Q000378:metabolism; D005755:Gastrins / Q000097:blood*; D006801:Humans; D006961:Hyperparathyroidism / Q000097:blood* / Q000209:etiology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010282:Parathyroid Neoplasms / Q000175:diagnosis; D010437:Peptic Ulcer / Q000150:complications; D012633:Secretin
chemical_list: D005755:Gastrins; D012633:Secretin