[Biological diagnosis of Zollinger-Ellison syndrome in the context of a polyendocrine adenomatosis]

Abstract

The diagnostic features of Zollinger-Ellison syndrome (ZES) in patients with type I poly-endocrine adenomatosis with a gastrinoma are analysed on the basis of 11 cases. Both from a clinical (frequency of ulcer disease and of diarrhoea) and biological standpoint (hypersecretion of gastric acid, hypergastrinaemia, or results of secretin stimulation test), the characteristics of ZES are not different whether a gastrinoma is present alone or in association with involvement of other endocrine glands. However the signs may be either masked by changes related to another endocrine disorder or appear late. They should therefore be sought routinely in all patients with an endocrine disorder which might fall into the context of a type I poly-endocrine adenomatosis. The sole difficulty is the interpretation of gastric acid hypersecretion and/or hypergastrinaemia in a patient with hyperparathyroidism. In this latter case, such abnormalities are not necessarily due to ZES and may disappear after removal of the parathyroid adenoma.