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Serum Gastrin Level Is Increased by Chronic Hypercalcemia of Parathyroid or Nonparathyroid Origin

Serum Gastrin Level Is Increased by Chronic Hypercalcemia of Parathyroid or Nonparathyroid Origin Abstract • In patients with hypercalcemia with abdominal symptoms, gastrin concentration is often measured to exclude the Zollinger-Ellison syndrome. We found that interpretation of such measurements is clouded by a contradictory literature. We therefore measured serum gastrin concentrations in 78 patients with primary hyperparathyroidism, 36 with nonparathyroid hypercalcemia, 13 with hypocalcemia, and 33 normocalcemic controls. Gastrin values above normal occurred in 22% of those with primary hyperparathyroidism and 28% of those with nonparathyroid hypercalcemia. Values above 250 pg/mL occurred only in those with hypochlorhydria or multiple endocrine neoplasia, type 1 (MEN 1). After parathyroidectomy, gastrin levels fell significantly, but elevated values tended to recur in those with MEN 1 if hypercalcemia recurred. Thus, chronic hypercalcemia of either parathyroid or nonparathyroid origin may elevate serum gastrin concentrations, but marked elevations suggest either achlorhydria or MEN 1. (Arch Intern Med 1986;146:478-482) References 1. Dent RI, James JH, Wang CA, et al: Hyperparathyroidism: Gastric acid secretion and gastrin. Ann Surg 1972;176:360-368.Crossref 2. Snyder N, Scurry M, Hughes W: Hypergastrinemia in familial multiple endocrine adenomatosis. Ann Intern Med 1974;80:321-325.Crossref 3. Stremple JF, Watson CG: Serum calcium and gastrin and gastric acid secretion before and after parathyroidectomy for hyperparathyroidism. Surgery 1974;75:841-852. 4. Wilson SD, Singh RB, Kalkhoff RD, et al: Does hyperparathyroidism cause hypergastrinemia? Surgery 1976;80:231-237. 5. Wesdorp RIC, Wang CA, Hirsch H, et al: Plasma and parathyroid tumor tissue gastrin and hyperparathyroidism. Am J Surg 1976;131:60-62.Crossref 6. Lamers CBH, Van Tongeren JHM: Serum gastrin response to acute and chronic hypercalcemia in man: Studies on the value of calcium stimulated serum gastrin levels in the diagnosis of Zollinger-Ellison syndrome. Eur J Clin Invest 1977;7:315-317.Crossref 7. Vantini I, Cominacini L, Ederle A, et al: Fasting serum gastrin in primary hyperparathyroidism and in chronic hypercalcemia. Acta Hepatogastroenterol 1979;26:472-477. 8. Selking 0, Johansson H, Lundquish G: Serum gastrin and its response in hyperparathyroid patients. Acta Chir Scand 1981;147:647-655. 9. Case records of the Massachusetts General Hospital. N Engl J Med 1976;294:37-42.Crossref 10. Isenberg JI, Walsh JH, Passaro E Jr, et al: Unusual effect of secretin on serum gastrin, serum calcium and gastric acid secretion in a patient with suspected Zollinger-Ellison syndrome. Gastroenterology 1972;62:626-631. 11. Yip B, Jordan PH Jr: Radioimmunoassay of gastrin using antiserum to porcine gastrin. Proc Soc Exp Biol Med 1970;134:380-385.Crossref 12. Mallette LE, Tuma SN, Berger RE, et al: Radioimmunoassay for the middle region of human parathyroid hormone using an homologous antiserum with a carboxy-terminal fragment of bovine PTH as radioligand. J Clin Endocrinol Metabol 1982;54:1017-1024.Crossref 13. Mallette LE, Bradley WA: Bovine parathyroid hormone (41-84), a hormone fragment with desirable properties for use as radioligand. J Lab Clin Med 1981;98:886-895. 14. Mallette LE, Silverman V: Hypercalcemia after acute renal failure. South Med J 1981;73:1453-1456.Crossref 15. Spjøtvoll E, Stoline MR: An extension of the T-method of multiple comparisons to include the cases with unequal sample sizes. J Am Stat Assoc 1973;68:975-978. 16. Tamhane AC: A comparison of procedures for multiple comparisons of means with unequal variances. J Am Stat Assoc 1979;74:471-480. 17. Trudeau WL, McGuigan JE: Effects of calcium on serum gastrin levels in the Zollinger-Ellison syndrome. N Engl J Med 1969;281:862-866.Crossref 18. Lamers CB, Stadil F, Van Tongeren JHM: Prevalence of endocrine abnormalities in patients with the Zollinger-Ellison syndrome and in their families. Am J Med 1978;64:607-612.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Serum Gastrin Level Is Increased by Chronic Hypercalcemia of Parathyroid or Nonparathyroid Origin

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References (19)

Publisher
American Medical Association
Copyright
Copyright © 1986 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1986.00360150076009
Publisher site
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Abstract

Abstract • In patients with hypercalcemia with abdominal symptoms, gastrin concentration is often measured to exclude the Zollinger-Ellison syndrome. We found that interpretation of such measurements is clouded by a contradictory literature. We therefore measured serum gastrin concentrations in 78 patients with primary hyperparathyroidism, 36 with nonparathyroid hypercalcemia, 13 with hypocalcemia, and 33 normocalcemic controls. Gastrin values above normal occurred in 22% of those with primary hyperparathyroidism and 28% of those with nonparathyroid hypercalcemia. Values above 250 pg/mL occurred only in those with hypochlorhydria or multiple endocrine neoplasia, type 1 (MEN 1). After parathyroidectomy, gastrin levels fell significantly, but elevated values tended to recur in those with MEN 1 if hypercalcemia recurred. Thus, chronic hypercalcemia of either parathyroid or nonparathyroid origin may elevate serum gastrin concentrations, but marked elevations suggest either achlorhydria or MEN 1. (Arch Intern Med 1986;146:478-482) References 1. Dent RI, James JH, Wang CA, et al: Hyperparathyroidism: Gastric acid secretion and gastrin. Ann Surg 1972;176:360-368.Crossref 2. Snyder N, Scurry M, Hughes W: Hypergastrinemia in familial multiple endocrine adenomatosis. Ann Intern Med 1974;80:321-325.Crossref 3. Stremple JF, Watson CG: Serum calcium and gastrin and gastric acid secretion before and after parathyroidectomy for hyperparathyroidism. Surgery 1974;75:841-852. 4. Wilson SD, Singh RB, Kalkhoff RD, et al: Does hyperparathyroidism cause hypergastrinemia? Surgery 1976;80:231-237. 5. Wesdorp RIC, Wang CA, Hirsch H, et al: Plasma and parathyroid tumor tissue gastrin and hyperparathyroidism. Am J Surg 1976;131:60-62.Crossref 6. Lamers CBH, Van Tongeren JHM: Serum gastrin response to acute and chronic hypercalcemia in man: Studies on the value of calcium stimulated serum gastrin levels in the diagnosis of Zollinger-Ellison syndrome. Eur J Clin Invest 1977;7:315-317.Crossref 7. Vantini I, Cominacini L, Ederle A, et al: Fasting serum gastrin in primary hyperparathyroidism and in chronic hypercalcemia. Acta Hepatogastroenterol 1979;26:472-477. 8. Selking 0, Johansson H, Lundquish G: Serum gastrin and its response in hyperparathyroid patients. Acta Chir Scand 1981;147:647-655. 9. Case records of the Massachusetts General Hospital. N Engl J Med 1976;294:37-42.Crossref 10. Isenberg JI, Walsh JH, Passaro E Jr, et al: Unusual effect of secretin on serum gastrin, serum calcium and gastric acid secretion in a patient with suspected Zollinger-Ellison syndrome. Gastroenterology 1972;62:626-631. 11. Yip B, Jordan PH Jr: Radioimmunoassay of gastrin using antiserum to porcine gastrin. Proc Soc Exp Biol Med 1970;134:380-385.Crossref 12. Mallette LE, Tuma SN, Berger RE, et al: Radioimmunoassay for the middle region of human parathyroid hormone using an homologous antiserum with a carboxy-terminal fragment of bovine PTH as radioligand. J Clin Endocrinol Metabol 1982;54:1017-1024.Crossref 13. Mallette LE, Bradley WA: Bovine parathyroid hormone (41-84), a hormone fragment with desirable properties for use as radioligand. J Lab Clin Med 1981;98:886-895. 14. Mallette LE, Silverman V: Hypercalcemia after acute renal failure. South Med J 1981;73:1453-1456.Crossref 15. Spjøtvoll E, Stoline MR: An extension of the T-method of multiple comparisons to include the cases with unequal sample sizes. J Am Stat Assoc 1973;68:975-978. 16. Tamhane AC: A comparison of procedures for multiple comparisons of means with unequal variances. J Am Stat Assoc 1979;74:471-480. 17. Trudeau WL, McGuigan JE: Effects of calcium on serum gastrin levels in the Zollinger-Ellison syndrome. N Engl J Med 1969;281:862-866.Crossref 18. Lamers CB, Stadil F, Van Tongeren JHM: Prevalence of endocrine abnormalities in patients with the Zollinger-Ellison syndrome and in their families. Am J Med 1978;64:607-612.Crossref

Journal

Archives of Internal Medicine – American Medical Association

Published: Mar 1, 1986

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