title: Presentation, response to lansoprazole therapy, and outcome of Zollinger-Ellison syndrome-like gastric acid hypersecretors.
abstract: OBJECTIVE
  To evaluate the clinical characteristics, response to treatment and outcome of Zollinger?Ellison syndrome (ZES)-like gastric acid hypersecretors.
  
  
  METHODS
  Over a 20-year period, patients with gastric acid hypersecretion in the absence of ZES were enrolled in an open label prospective trial evaluating the efficacy of lansoprazole. Following baseline evaluations, patients were treated with escalating doses of lansoprazole based on the results of gastric acid analysis. Following stabilization, patients were followed on a 6 monthly basis with interval history, physical examination, endoscopy with gastric biopsies, gastric acid analysis, and laboratory studies.
  
  
  RESULTS
  The study group represented 21 patients (median age 47 years, 86% male, 91% Caucasian). Historically, complicated ulcer disease was frequent and symptoms had been present for a median of 10 years before study entry. All patients responded to lansoprazole (median dose 90 mg/day) with excellent control of gastric acid hypersecretion. Mucosal relapse was infrequent and no major complications developed while on therapy.
  
  
  CONCLUSIONS
  ZES-like gastric acid hypersecretion presents similarly to the classic syndrome. Lansoprazole titrated to gastric acid output is effective in healing mucosal disease and preventing relapse.
authors.affiliation: Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Charles Mel
authors.initials: CM
authors.lastname: Wilcox
authors.forename: Toni
authors.initials: T
authors.lastname: Seay
authors.forename: Justin
authors.initials: J
authors.lastname: Arcury
authors.forename: Basil I
authors.initials: BI
authors.lastname: Hirschowitz
mesh_terms: D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000008:administration & dosage / Q000627:therapeutic use*; D000328:Adult; D000897:Anti-Ulcer Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001706:Biopsy; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D005744:Gastric Acid / Q000378:metabolism*; D005745:Gastric Acidity Determination; D005753:Gastric Mucosa / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D005755:Gastrins / Q000097:blood; D005773:Gastroscopy; D006801:Humans; D064747:Lansoprazole; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013270:Stomach / Q000503:physiopathology; D013276:Stomach Ulcer / Q000188:drug therapy / Q000209:etiology; D016896:Treatment Outcome; D015043:Zollinger-Ellison Syndrome
chemical_list: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents; D005755:Gastrins; D064747:Lansoprazole