Feb 15, 2011

The Zollinger-Ellison syndrome and mismeasurement of gastrin

Jens F RehfeldPierre Poitras


Zollinger-Ellison syndrome (ZES) is characterized by hypersecretion of gastric acid, severe peptic ulcerations in the upper small intestine, and diarrhea. It is usually diagnosed by measuring increased levels of gastrin in plasma. We examined the accuracy of commercial kits to measure gastrin (7 radioimmunoassays and 5 enzyme-linked immunosorbent assays), using plasma from 40 patients suspected or known to have ZES. Each sample was analyzed using the 12 kits and a reference assay that measures bioactive gastrin in plasma, irrespective of size and amino acid derivatization. Known concentrations of peptides with identical sequences to circulating gastrins were also assessed by all assays. Molecular patterns in plasma from patients with ZES were examined by chromatography and monitored by kits that measure false-low or false-high concentrations of gastrin. Failure to diagnose gastrinomas has serious consequences. Four kits found false-low concentrations of gastrin in 20% to 80% of the patients. Specificity assessment showed that the antibodies used in these kits bound only gastrin-17. Three kits found false-high concentrations of gastrin, because the reagents had increased reactions to sulfated gastrins or to unspecific factors in...Continue Reading

  • References27
  • Citations33


Mentioned in this Paper

Human plasma
Endoscopy, Gastrointestinal
Proton Pump Inhibitors
Neuroendocrine Tumors
Proton Pump Inhibitors [MoA]
Kidney Failure, Acute
Primary Neoplasm
Small Intestinal Wall Tissue

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