A Duodenal Gastrinoma in a Patient with Diarrhea and Normal Serum Gastrin Concentrations

doi:10.1056/NEJM199509073331005

Volume 333:634-637		September 7, 1995		Number 10

A Duodenal Gastrinoma in a Patient with Diarrhea and Normal Serum Gastrin Concentrations

Thomas Zimmer, M.D., Ulrich Stölzel, M.D., Michael Bäder, M.D., Ute Fett, M.D., Hans-Dieter Foss, M.D., Ernst-Otto Riecken, M.D., Jens F. Rehfeld, M.D., and Bertram Wiedenmann, M.D.

Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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The Zollinger–Ellison syndrome manifests itself in 90to 95 percent of cases as severe peptic ulcer disease.¹ Abouthalf the time, the ulcer disease is associated with diarrhea,and in approximately 10 percent of patients, diarrhea is theonly clinical manifestation.²^,³ Basal serum gastrin concentrationsare usually elevated in patients with this syndrome.⁴ Normalbasal serum gastrin values with abnormal results of secretintests have been reported, however, in a few patients.⁵^,⁶^,⁷

We describe a patient with a duodenal gastrinoma, a two-yearhistory of diarrhea, and no peptic ulcer disease. The patienthad persistently normal serum gastrin concentrations, but abnormal. . . [Full Text of this Article]

Case Report

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From the Departments of Gastroenterology (T.Z., U.S., E.-O.R., B.W.), Nuclear Medicine (M.B., U.F.), and Pathology (H.-D.F.), Klinikum Benjamin Franklin, Free University of Berlin, Berlin, Germany; and the Department of Clinical Biochemistry, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark (J.F.R.).

Address reprint requests to Dr. Wiedenmann at Abt. Gastroenterologie, Universitätsklinikum Benjamin Franklin, Freie Universität Berlin, Hindenburgdamm 30, 12200 berlin, Germany.

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