title: Diagnosis of Zollinger-Ellison syndrome: increasingly difficult.
abstract: In the present paper the increasing difficulty of diagnosis of Zollinger-Ellison syndrome (ZES) due to issues raised in two recent papers is discussed. These issues involve the difficulty and need to withdraw patients suspected of ZES from treatment with Proton Pump Inhibitors (omeprazole, esomeprazole, lansoprazole, rabeprazole, pantoprazole) and the unreliability of many gastrin radioimmunoassays. The clinical context of each of these important issues is reviewed and the conclusions in these articles commented from the perspective of clinical management.
authors.affiliation: Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Tetsuhide
authors.initials: T
authors.lastname: Ito
authors.forename: Guillaume
authors.initials: G
authors.lastname: Cadiot
authors.forename: Robert T
authors.initials: RT
authors.lastname: Jensen
mesh_terms: D000075202:Contraindications; D005755:Gastrins / Q000097:blood; D006801:Humans; D054328:Proton Pump Inhibitors; D015043:Zollinger-Ellison Syndrome / Q000097:blood / Q000175:diagnosis*
chemical_list: D005755:Gastrins; D054328:Proton Pump Inhibitors
keywords: Gastrin; Gastrinoma; Hypergastrinemia; Neuroendocrine tumor; Secretin test; Serum gastrin; Zollinger-Ellison syndrome